Sr Claim Specialist - Casualty

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Job Type:

Job Description:

Sr Claim Specialist - Casualty - The Auto Club Group

What you will do:
* Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.
* Complete coverage analysis on the most complex claims.
* Ensure all possible policyholder benefits are identified.
* Create additional sub-claims if needed.
* Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential.
* Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
* Evaluate the financial value of the loss.
* Approve payments for the appropriate parties accordingly.
* Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
* Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
* Utilize strong negotiating skills.

Senior Claim Specialists are assigned Liability/BI/MedPay/Non-MI PIP claims involving litigation/arbitration. Handle the most complex claims involving liability disputes, bodily injuries, and coverage questions.

How you will benefit:

Sr Claim Specialist will earn a competitive salary of $73,000 to $95,000 annually with annual bonus potential based on performance.

• Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include:
• 401k Match
• Medical
• Dental
• Vision
• PTO
• Paid Holidays
• Tuition Reimbursement

We're looking for candidates who:

Required Qualifications (these are the minimum requirements to qualify)

Education:

• Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
• In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states.
• Must have a valid State Driver's License

Experience:

• Five years of experience in the following:
• negotiation of complex claim settlements

• securing and evaluating evidence
• preparing manual and electronic estimates
• subrogation claims
• resolving complex coverage questions
• taking statements
• establishing clear evaluation and resolution plans for claims

Knowledge and Skills:

• Advanced technical knowledge of

• Essential Insurance Act (Michigan)
• Fair Trade Practices Act as it relates to claims
• Subrogation procedures and processes
• Intercompany arbitration
• Litigation

Advanced technical knowledge of:

• Negligence Law
• No-Fault Law
• medical terminology and human anatomy
• Insurance Policy Review and Understanding
• Coverage Review and Writing
• advanced technical knowledge of building construction and repair techniques

Ability to:

• handle claims to the line Claim Handling Standards
• follow and apply ACG Claim policies, procedures and guidelines

• work within assigned ACG Claim systems including basic PC software
• perform claim file review and investigations
• demonstrate effective communication skills (verbal and written)
• demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
• analyze and solve problems while demonstrating sound decision making skills
• prioritize claim related functions
• process time sensitive data and information from multiple sources
• manage time, organize and plan work load and responsibilities
• safely operate a motor vehicle in order to attend meetings off site
• travel outside of assigned territory which may involve overnight stay
• relocate, work evenings or weekends

Preferred Qualifications

Education:

• Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
• Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent
• CPCU coursework or designation

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Who We Are

Become a part of something bigger.

The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.

By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance.

And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other.

We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.

To learn more about AAA The Auto Club Group visit