Claim Representative II - PIP

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.

Tampa, FL

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: <div id="overview" class="job-summary-section ng-scope"> <div class="full-text ng-binding">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.</div> </div> <div id="gtx-trans" style="position: absolute; left: 274px; top: 25.3608px;">&nbsp;</div>
Responsibilities: <p align="left"><span style="font-family: Arial;">The Auto Club Group is seeking prospective&nbsp;<strong>Claim Representative II</strong>&nbsp;who can&nbsp;</span><span style="font-family: Arial;">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 resolution plans for claims.</span></p> <div align="left"><span style="font-family: Arial;">&nbsp;</span></div> <div align="left"><span style="font-family: Arial;">In this position, you will have the opportunity to:</span></div> <ul> <li> <p align="left"><span style="font-family: Arial;">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;</span></p> </li> <li> <p align="left"><span style="font-family: Arial;">Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss.</span></p> </li> <li> <p align="left"><span style="font-family: Arial;">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;</span></p> </li> <li> <p align="left"><span style="font-family: Arial;">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.</span></p> </li> <li> <p align="left"><span style="font-family: Arial;">Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.</span></p> </li> <li> <p align="left"><span style="font-family: Arial;">Evaluate the financial value of the loss.</span></p> </li> <li> <p align="left"><span style="font-family: Arial;">Approve payments for the appropriate parties accordingly.&nbsp;</span></p> </li> <li> <p align="left"><span style="font-family: Arial;">Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).&nbsp;</span></p> </li> <li> <p align="left"><span style="font-family: Arial;">Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.&nbsp;</span></p> </li> <li> <div align="left"><span style="font-family: Arial;">Utilize strong negotiating skills.</span></div> </li> </ul> <p align="left">&nbsp;</p> <p align="left"><span style="font-family: Arial;">Employees assigned to the Liability, Bodily Injury, Med Pay, MRTS and Non-MI PIP claim units will handle moderately complex claims involving liability disputes, bodily injuries, and generally valued up to $50,000.&nbsp; Answer coverage and policy questions.&nbsp; Handle Med Pay claims in all states, and PIP claims in KY, MN and ND.&nbsp; Apply the correct liability determination, evaluate the damages and arrive at a fair settlement.</span></p> <p align="left"><span style="font-family: Arial;">Employees assigned to PIP claim unit are responsible for Michigan PIP Fast Track claims involving minor injuries.&nbsp; Claims will include emergency room treatment and release, primary care physician treatment, and injuries requiring very little follow-up care.&nbsp; May handle losses beyond those identified previously. Work with insureds, physicians&rsquo; offices and medical insurance carriers to obtain necessary information to complete the claims review process and make the appropriate determinations.</span></p> <p align="left"><span style="font-family: Arial;">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.</span></p>
Requirements: <div align="left"><u><span style="font-family: Arial;">Education:</span></u></div> <ul type="disc"> <li><span style="font-family: Arial;">Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience</span></li> <li><span style="font-family: Arial;">Completion of the Insurance Institute of America&rsquo;s: General Insurance Program, Associate in Claims, Associate in Management or equivalent</span></li> <li><span style="font-family: Arial;">CPCU coursework or designation</span></li> <li><span style="font-family: Arial;">I-Car 2000 training</span></li> <li><span style="font-family: Arial;">CCC training</span></li> <li><span style="font-family: Arial;">Xactware Training</span></li> <li><span style="font-family: Arial;">Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience</span></li> <li><span style="font-family: Arial;">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.</span></li> <li><span style="font-family: Arial;">Must have a valid State Driver&rsquo;s License</span></li> </ul> <div align="left"><span style="font-family: Arial;">&nbsp;</span></div> <div align="left"><u><span style="font-family: Arial;">&nbsp;Experience:</span></u></div> <ul type="disc"> <li><span style="font-family: Arial;">One year of experience with:</span></li> <li><span style="font-family: Arial;">Negotiating claim settlements</span></li> <li><span style="font-family: Arial;">Securing and evaluating evidence</span></li> <li><span style="font-family: Arial;">Preparing manual and electronic estimates</span></li> <li><span style="font-family: Arial;">Subrogation claims</span></li> <li><span style="font-family: Arial;">Resolving coverage questions</span></li> <li><span style="font-family: Arial;">Taking statements</span></li> <li><span style="font-family: Arial;">Establishing clear evaluation and resolution plans for claims</span></li> </ul> <div align="left"><u><span style="font-family: Arial;">Knowledge and Skills:</span></u></div> <div align="left"><span style="font-family: Arial;">Knowledge of:</span></div> <ul type="disc"> <li><span style="font-family: Arial;">Essential Insurance Act (Michigan)</span></li> <li><span style="font-family: Arial;">Fair Trade Practices Act as it relates to claims</span></li> <li><span style="font-family: Arial;">Subrogation procedures and processes</span></li> <li><span style="font-family: Arial;">Intercompany arbitration</span></li> </ul> <p align="left">&nbsp;</p> <p align="left"><strong><span style="font-family: Arial;">&nbsp;</span></strong></p> <p><span style="font-family: Arial;">Knowledge of:</span></p> <p>&nbsp;</p> <ul type="disc"> <li><span style="font-family: Arial;">Negligence Law</span></li> <li><span style="font-family: Arial;">No-Fault Law</span></li> <li><span style="font-family: Arial;">Medical terminology and human anatomy</span></li> </ul> <p align="left"><span style="font-family: Arial;">&nbsp;</span></p> <p align="left"><span style="font-family: Arial;">Ability to:</span></p> <ul type="disc"> <li><span style="font-family: Arial;">Handle claims to the line Claim Handling Standards</span></li> <li><span style="font-family: Arial;">Follow and apply ACG Claim policies, procedures and guidelines</span></li> <li><span style="font-family: Arial;">Work within assigned ACG Claim systems including basic PC software</span></li> <li><span style="font-family: Arial;">Perform basic claim file review and investigations</span></li> <li><span style="font-family: Arial;">Demonstrate effective communication skills (verbal and written)</span></li> <li><span style="font-family: Arial;">Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns</span></li> <li><span style="font-family: Arial;">Analyze and solve problems while demonstrating sound decision making skills</span></li> <li><span style="font-family: Arial;">Prioritize claim related functions</span></li> <li><span style="font-family: Arial;">Process time sensitive data and information from multiple sources</span></li> <li><span style="font-family: Arial;">Manage time, organize and plan work load and responsibilities</span></li> <li><span style="font-family: Arial;">Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc.</span></li> <li><span style="font-family: Arial;">Research analyze and interpret subrogation laws in various states</span></li> <li><span style="font-family: Arial;">Travel outside of assigned territory which may involve overnight stay</span></li> <li><span style="font-family: Arial;">Relocate, work evenings or weekends</span></li> <li><span style="font-family: Arial;">Strong negotiating skills</span></li> </ul> <p align="left">&nbsp;</p> <div align="left"><span style="font-family: Arial;">Important Note:</span></div> <p align="left"><span style="font-family: Arial;">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 fulfil these requirements.</span></p> <p><span style="font-family: Arial;">The Auto Club Group, and all of its affiliated companies, is an equal opportunity/affirmative action employer. &nbsp;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.</span></p>