Catastrophe Field Claims Specialist

Role Overview

• Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.
• Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system.
• Complete complex coverage analysis.
• Ensure all possible policyholder benefits are identified.
• Create additional sub-claims if needed.
• 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.
• Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
• Evaluate the financial value of the loss.
• Approve payments for the appropriate parties accordingly.
• Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
• Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
• Utilize strong negotiating skills.
• Employees assigned to Auto Physical Damage (“APD”) claim unit will handle complex claims involving settling Total Losses, inspecting vehicles and preparing estimates of damage.
• Additional responsibilities may include the following: determining cause of damage, establishing liability, and identifying subrogation potential.
• Monitor repairs and approve car rental expense.
• Oversee APD Litigation cases. Manage the litigation process including attorney and budget management, participation in mediation activities and determining the appropriate settlement position.

Requirements

• Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
• In states where an Adjuster’s license is required, the candidate must be eligible to acquire a State Adjuster’s license within 90 days of hire and maintain as specified for appropriate states.
• Must have a valid State Driver's License
• Three years of experience or equivalent training in the following:
• negotiation of claim settlements
• securing and evaluating evidence
• preparing manual and electronic estimates
• subrogation claims
• resolving coverage questions
• taking statements
• establishing clear evaluation and resolution plans for claims
• Advanced knowledge of:
• Essential Insurance Act (Michigan)
• Fair Trade Practices Act as it relates to claims
• subrogation procedures and processes
• intercompany arbitration
• handling simple litigation
• advanced knowledge of building construction and repair techniques
• Ability to:
• handle claims to the line Claim Handling Standards
• follow and apply ACG Claim policies, procedures and guidelines
• work within assigned ACG Claim systems including basic PC software
• perform basic claim file review and investigations
• demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
• analyze and solve problems while demonstrating sound decision making skills
• prioritize claim related functions
• process time sensitive data and information from multiple sources
• manage time, organize and plan work load and responsibilities
• safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc.
• research, analyze and interpret subrogation laws in various states
• travel outside of assigned territory which may involve overnight stay
• relocate, work evenings or weekends

Benefits

• 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!