Claim Customer Service Representative

AAA Auto Club Auburn Hills, MI
The Auto Club Group (ACG) provides membership, travel, insurance and financial services offerings to approximately 9 million members and customers across 11 states and 2 U.S. territories through the AAA, Meemic and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.

Primary Duties and Responsibilities (details of the basic job functions):

Responsible for taking first notice of loss, handling claim inquiries, initiating claim services, and handling low-complexity claims in a call center environment.

Reviews non-complex claims on assignment. Determines the type and extent of loss and ensures the claim is consistent with all reported facts. Reviews necessary legal and police/fire reports to process claims as necessary. Interprets policy language and applies coverage to authorize or deny claims. Monitors, authorizes, and resolves issues related to services such as car rental and vehicle repairs and non-complex homeowner claims (e.g. food spoilage). Authorizes payments, settles or recommends settlement value of claims within specified limits. Identifies additional claim exposures, creates sub-claims and reassigns as necessary. Refers files for investigation as warranted. Proactively contacts insureds, claimants and third parties. Responds to claimant inquiries and explains payments. Documents claim files. Reviews the status of open and closed reserves and makes adjustments consistent with exposures. Reviews assigned claim files on diary for progress toward completion of settlements. Reviews claims for salvage and subrogation potential and handles in accordance to company policy. Closes claims in a timely manner. Ensure compliance with state regulations. Assumes responsibility for claims that were previously assigned to other claim staff members as necessary.

Completes claims first notices of loss and handles inquiries per inbound calls, the ACG website and other sources. Takes a basic claims report of loss as appropriate and refers to appropriate individual for follow-up. Explains the benefits of company programs to customers. Initiates services, such as arranging for repair inspections, vehicle tows and car rental. Provides basic information to members regarding claims procedures in accordance with Customer Interaction Model. Promotes customer satisfaction and provide seamless service to ensure customer service goals and standards are met. Navigates through various sources of information (FACTS, P.C., Point of Sale and IPM insurance systems, manuals, call center models, Intranet/Internet, etc.) and responds to members/customers questions in a timely manner. Provides Accident Assist claims services such as proactively contacting customers at requested times for handling first notices of loss, coordinating vehicle tow activities with AAA Emergency Road Service (ERS) and documenting results, completing courtesy follow-up calls with customers, etc.

Preferred Qualifications:

Education:

* Associate's degree in Business Administration or a related field, or the equivalent in related work experience.

* Completion of (IIA) Insurance Institute of America or other insurance coursework.

Experience to include:

* A claim related field such as insurance, automotive, medical or legal services

* a call center environment

* utilizing ACG automated systems

* investigating and resolving claims related problems

* handling claims or claim support tasks such as processing glass claims, car rentals, invoice payments, etc.

Knowledge of:

* ACG insurance processes and procedures

* auto and home repair basics and cost estimating

* State insurance laws

* regulatory compliance requirements

* property and casualty insurance policy language and provisions

* claims quality service standards

* liability, negligence, No-Fault principles and subrogation

Work Environment:

Works in a temperature controlled office environment.

Required Qualifications (these are the minimum requirements to qualify):

Education (include minimum education and any licensing/certifications):

* Completion of AAA approved call center training program and ongoing training and certification for the position

* Must be eligible to acquire and maintain a State adjuster's license for appropriate state(s).

Experience:

* processing first notice of loss (FNOL) information and handling claim inquiries via the telephone

* utilizing PCs and software packages (e.g. Microsoft Word, Excel)

* reading and comprehending various Customer Care service tools (manuals, work models, etc.)

* performing mathematical calculations including adding, subtracting, percentages, etc.

* analyzing and resolving problems

Knowledge and Skills:

Knowledge of:

* claim processing policy and procedures

* general claim processing functions

* claim processing systems

* telephone etiquette

Ability to provide a high level of customer service in a professional call center environment using the following skills:

* Strong interpersonal skills demonstrated through work experience, participation in extra-curricular activities and/or community involvement.

* Strong communication skills required in understanding customers' concerns and to provide high quality customer service as demonstrated through the effective use of the customer care call center model.

* Excellent verbal communication skills service.

* Strong written communications skills (example may be required at time of interview) needed to respond in a professional manner to members/customers inquiries.

* Effective listening skills.

Ability to learn and apply claim handling skills, including:

* policy analysis and coverage application

* claim payment coding, issuance, and exception handling

* proactive customer contact and issue resolution

* car rental coverage knowledge

* claims' related policies and procedures

* auto and home repair estimate basics and compliance review

* state compliance requirements

* subrogation identification and referral (e.g. MI liability basics regarding uninsured motorists)

* understand insurance fraud scenarios and recognize potential fraud indicators

* issue written correspondence

* prioritize claims-related functions

Ability to:

* successfully complete at least one of the following within 9 months of hire:

* AAA general claim policy training;

* policy, negligence and no-fault training

* proactively contact and effectively interact with the public and business partners through out-bound communication

* work independently

* communicate effectively over the telephone

* work under pressure

* record and maintain information accurately and in a timely fashion

* work effectively in a team environment

* sit for the majority of the work day

* Willingness and ability to work irregular shifts, including weekends and holidays.

* Willingness to relocate.

The Auto Club Group offers a competitive compensation and benefits package including a base salary with performance based incentives; medical/dental/vision insurance, 401(k), generous time off, a complimentary AAA Membership and much more!

Important Note: The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.

The Auto Club Group, and all of its affiliated companies, is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.

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