Claim Analyst - Reinsurance

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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Competitive Compensation and Benefits Package

Overview: <p>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.</p> <p><strong><u>Work Environment:</u></strong></p> <p>Work in a temperature-controlled office environment. Occasional (less than 20% of work time) travel may be required in order to conduct training in various locations.</p> <strong><br /> <u>Compensation</u></strong><br /> The Auto Club Group offers a 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: <p>Use Web Based and other applications to bill, document or analyze work. Refer callers to appropriate individuals for additional information as needed. May represent company at trials, depositions and settlement hearings.</p> <p>Perform billing functions to the MCCA. Ensure all requests for reimbursements are submitted timely and accurately to the MCCA. Review all claims that were not submitted through the automatic submission for potential errors and completion of the corrections. Identify and correct incorrect benefit types, duplicate payments, subrogation issues and refunds. Ensure that claims are balanced using financial reports to ensure funds are received and exceptions are placed in a diary system that must be monitored every 30 days. Work as a liaison between our reinsurer and the claim representatives in the field to ensure all funds are recovered.</p>
Requirements: <p><strong><u>Preferred Qualifications:</u></strong></p> <p><strong>Education:</strong></p> <ul> <li>Associate's degree in Business Administration, Insurance or a related field.</li> <li>Completion of the Insurance Institute of America's: General Insurance Program,&nbsp;Associate in Claims, Associate in Management or equivalent</li> <li>CPCU coursework or designation</li> </ul> <p><strong>Experience:</strong></p> <ul> <li>Significant medical bill review experience.</li> </ul> <p><strong>Knowledge of:</strong></p> <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> </ul> <p><strong><u>Qualifications</u></strong></p> <p><strong>Required Qualifications (these are the minimum requirements to qualify):</strong></p> <p><strong>Education (include minimum education and any licensing/certifications):</strong></p> <ul> <li>College level coursework in Business Administration, Insurance or a related field or the equivalent in related work experience.</li> </ul> <p><strong>Experience:</strong></p> <ul> <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> <p><strong>Knowledge and Skills:</strong></p> <p>Knowledge of one or more of the following:</p> <ul> <li>Medical terminology and human anatomy.</li> <li>Property and casualty claims process and procedures.</li> <li>FACTS, IPM and CPS.</li> </ul> <p>Ability to:</p> <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 review.</li> </ul> <p>Demonstrated skill in:</p> <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>