Claim Analyst

A career at The Auto Club Group (ACG) can be satisfying, exciting and rewarding. By aligning your professional development with our business objectives, ACG can help you attain your career goals — and make a difference. Get started by choosing the career that’s right for you.

Dearborn, MI

The Auto Club Group

AAA was founded over 100 years ago for the purpose of lobbying for driver and passenger rights, fair laws and safer vehicles — all to better promote the love of the open road and the adventure of driving. Since then, AAA has grown to over 50 million members strong, while providing valuable membership services such as roadside assistance. Additionally, AAA has broadened its horizons to include all types of travel-related services, as well as offer a variety of insurance and financial products and services. Today’s AAA is a national federation comprised of more than 50 individual clubs throughout the United States and Canada. Whether you’re traveling around the world or to the corner grocery store, planning a honeymoon or weekend road trip, learning to drive or in need of a battery boost, the best way to begin your journey is with AAA.

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Full Time

Competitive Compensation and Benefits Package

Overview: <strong>About ACG:</strong><br />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.<br /><br /><strong>Compensation:</strong><br />The Auto Club Group offers competitive compensation and benefits packages including a base salary with performance-based incentives; medical/dental/vision insurance, pension, 401(k), generous time off, a complimentary AAA Membership, and much more!
Responsibilities: <ul> <li>The Auto Club Group is seeking prospective Claim Analysts who will use web-based and other applications to bill, document, or analyze work.</li> <li>This individual will refer callers to appropriate individuals for additional information as needed and may represent the company at trials, depositions, and settlement hearings.</li> <li>Approve reasonable and customary payments in accordance with corporate guidelines and document payment/rejection information in Mitchell Medical diary to monitor expenditures, ensure coordination of benefits and avoid duplicate payments.</li> <li>Act as a liaison between the customer, and providers in order to: research payment status, explain payment amounts approved. Researching and assigning lawsuits received.</li> </ul>
Requirements: <strong>Education:</strong><br /> <ul> <li>College-level coursework in Business Administration, Insurance or a related field or the equivalent in related work experience</li> <li>Professional Coder Certification (CPT) for MBRU function</li> <li>completion of the Insurance Institute of America&rsquo;s: General Insurance Program, Associate in Claims, Associate in Management or equivalent</li> <li>CPCU coursework or designation</li> </ul> <br /><strong>Experience:</strong><br /> <ul> <li>Significant medical bill analysis experience</li> <li>Claim analysis, or similar function</li> <li>Medical bill review (cost containment) operating a personal computer</li> <li>Utilizing software packages (e.g. Word, Excel, Access, Powerpoint, Visio, etc.)</li> </ul> <br /><strong>Knowledge of:</strong><br /> <ul> <li>Negligence Law</li> <li>No-Fault Law</li> <li>Essential Insurance Act</li> <li>Fair Trade Practices Act as they relate to claims</li> <li>Auto Insurance Policy contract and coverages</li> <li>Medical terminology and human anatomy</li> <li>CPT, ICD-9, and 10, and revenue codes (MBRU)</li> <li>Property and casualty claims process and procedures</li> <li>FACTS, IPM, and CPS&rsquo;</li> </ul> <br /><strong>Ability to:</strong><br /> <ul> <li>Use automated processing systems</li> <li>Effectively respond to questions/concerns</li> <li>Communicate effectively with others in a work environment, with the public and vendors</li> <li>Independently perform detailed, complex medical bill or similar analysis</li> </ul> <br /><strong>Demonstrated skill in:</strong><br /> <ul> <li>Organization and planning</li> <li>Analyzing and problem-solving</li> <li>Written communications to include record keeping and report preparation</li> <li>Decision making</li> <li>Negotiating</li> </ul> <br />Important Note: The above statements describe the principle 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.<br /><br />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.