Claim Customer Service Representative

Role Overview

• Claim Customer Service Representatives will be responsible for taking first notice of loss, handling claim inquiries, initiating claim services, and handling low-complexity, one-touch claims in a call center environment
• Identifies non-complex claims for one-touch claim adjudication upon intake
• 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
• Initiates services, authorizes, and resolves issues related to services such as car rental and vehicle repairs and non-complex homeowner claims (e.g. food spoilage)
• Initiates and creates payments, settles or recommends settlement value of claims within specified limits
• Identifies additional claim exposures and creates sub-claims as necessary
• Refers files for investigation as warranted
• Informs insured of coverage decision on claims within defined scope
• Responds to claimant inquiries and explains payments
• Reviews the status of open and closed reserves and adjusts consistent with exposures
• Identify claims for salvage and subrogation potential in accordance to company policy
• Ensure compliance with state regulations
• Completes first notice of loss for all policy products and handles inbound claim inquiries received via phone, the ACG website and other sources
• Explains the benefits of company programs to customers, and initiate 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 provides seamless service to ensure customer service goals and standards are met
• Navigates through various sources of information and claim processing systems (E.g., FACTS, CPS, Point of Sale, IPM insurance systems, Intranet/Internet, manuals and call center models)
• Responds to members/customers questions in a timely manner

Requirements

• High School Diploma or equivalent
• Completion of AAA approved call center training program, appropriate level ACG Claim Representative 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)
• Processing FNOL information and handling claim inquiries utilizing PCs and software packages (e.g. ACG claim systems, 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 of claim processing policy and procedures
• General claim processing functions
• Claim processing systems
• Telephone etiquette

Benefits

• A competitive hourly salary between $19.00
• $22.00
• Medical, dental and vision benefits
• 401k Match
• Paid parental leave and adoption assistance
• Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
• Paid volunteer day annually
• Tuition assistance program, professional certification reimbursement program and other professional development opportunities
• AAA Membership Discounts, perks, and rewards and much more