Remote PIP Claim Representative II

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.

Remote

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. http://michigan.aaa.com/

keywords: compensation,about acg,analysis,benefits,claims,management,quality assurance,investigate,analysis,skills,experience,compliance,process,education

Full Time

Competitive Compensation and Benefits Package

Overview: <p class="p1">About ACG</p> <p class="p1">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 class="p2">&nbsp;</p> <p class="p1">Compensation</p> <p class="p1">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!</p>
Responsibilities: <strong>Job Description</strong> <p>&nbsp;</p> <p><strong>Remote Claim Representative II &ndash; FL PIP&nbsp;&ndash; The Auto Club Group</strong></p> <p><strong>What you will do:</strong></p> <p>The Auto Club Group is seeking prospective&nbsp;<strong>Claim Representative II</strong>&nbsp;who can work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements and establish clear evaluation and&nbsp;resolution plans for claims.&nbsp; The Auto Club Group&rsquo;s PIP department is growing rapidly and is interested in all candidates with any type of PIP experience.</p> <p>&nbsp;In this Claim Representative II position, you will have the opportunity to:</p> <ul> <li>Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system.&nbsp;&nbsp;</li> <li>Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss.</li> <li>Ensure all possible policyholder benefits are identified, create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler.&nbsp;</li> <li>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.</li> <li>Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.</li> <li>Evaluate the financial value of the loss.</li> <li>Approve payments for the appropriate parties accordingly.&nbsp;</li> <li>Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).&nbsp;</li> <li>Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.&nbsp;</li> <li>Utilize strong negotiating skills.&nbsp;</li> </ul> <p>With our powerful brand and the mentoring we offer, you will find your position as a&nbsp;<strong>Claims Representative II&nbsp;</strong>can lead to a rewarding career at our growing organization.</p> <p><strong>How you will benefit:</strong></p> <ul> <li>Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include: <ul> <li>401k Match</li> <li>Medical</li> <li>Dental</li> <li>Vision</li> <li>PTO</li> <li>Paid Holidays</li> <li>Tuition Reimbursement</li> </ul> </li> </ul>
Requirements: <p><strong>Qualifications</strong></p> <p><strong>We&rsquo;re looking for candidates who:</strong></p> <p><u>Education:</u></p> <ul> <li>High School Diploma</li> <li>4 year degree preferred</li> <li>Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience</li> <li>In states where an Adjuster&rsquo;s license is required, the candidate must be eligible to acquire a State Adjuster&rsquo;s license within 90 days of hire and maintain as specified for appropriate states.</li> <li>Must have a valid State Driver's License</li> </ul> <p><u>Experience:</u></p> <p>The ideal candidate will have experience in, at least, one of the below skill sets:</p> <ul> <li>Two or more years of Personal Injury Protection benefits experience</li> <li>Negotiating claim settlements</li> <li>Securing and evaluating evidence</li> <li>Subrogation claims</li> <li>Resolving coverage questions</li> <li>Taking statements</li> <li>Establishing clear evaluation and resolution plans for claims</li> <li>Medical management</li> </ul> <ul> <li>Interpreting policy language</li> <li>Florida statute knowledge</li> <li>Letter writing</li> </ul> <p><u>Required Skills</u></p> <ul> <li>Handle claims to the line Claim Handling Standards</li> <li>Follow and apply ACG Claim policies, procedures and guidelines</li> <li>Work within assigned ACG Claim systems including basic PC software</li> <li>Perform basic claim file review and investigations</li> <li>Demonstrate effective communication skills (verbal and written)</li> <li>Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns</li> <li>Analyze and solve problems while demonstrating sound decision making skills</li> <li>Prioritize claim related functions</li> <li>Process time sensitive data and information from multiple sources</li> <li>Manage time, organize and plan work load and responsibilities</li> <li>Research analyze and interpret subrogation laws in various states</li> <li>Work evenings or weekends</li> <li>Strong negotiating skills</li> </ul>