About this role
Role Overview
- Evaluate coverage for assigned claims.
- Assess claim exposures and make informed decisions for resolution.
- Manage challenging and complex claim scenarios while ensuring compliance with regulations.
- Review assigned claims and initiate claim handling activities.
- Contact insureds and other affected parties to gather information.
- Document claim activity and maintain accurate records.
- Perform complex coverage analysis and identify applicable policyholder benefits.
- Establish and manage sub-claims as needed.
- Conduct thorough investigations to determine coverage applicability, claim validity, and other relevant factors.
- Negotiate settlements and claim resolutions.
- Refer claims to specialized departments when necessary.
- Ensure complete and accurate claim documentation and compliance with procedures.
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.
- A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.
- Three years of experience or equivalent training in negotiating claim settlements, securing and evaluating evidence, preparing manual and electronic estimates, handling subrogation claims, resolving coverage questions, and establishing clear evaluation and resolution plans for claims.
- Advanced knowledge of the Essential Insurance Act (Michigan), Fair Trade Practices Act as it relates to claims, subrogation procedures and processes, intercompany arbitration, handling simple litigation, negligence law, No-Fault law medical terminology and human anatomy, MCCA, and attorney represented claims.
Benefits
- Medical plans with multiple coverage options, including HSA eligibility.
- Prescription drug coverage.
- Dental and vision benefits.
- Employee Assistance Program (confidential support services).
- Company-paid basic life insurance.
- Optional supplemental life insurance and dependent coverage.
- Short-term and long-term disability coverage.
- Critical illness, accident, and pet insurance options.
- 401(k) plan to support long-term financial goals.
- 3% automatic deferral upon eligibility; may contribute 1% to 50% of eligible earnings, either pre or post tax.
- Company match of 50% paid on employee contributions up to 6% of pay, payable to employees following the end of the year; immediate vesting.
- Additional company contribution of 4% of pay each pay day into your account; 100% vested after three (3) years of service.
- Health Savings Account (HSA) and Flexible Spending Accounts (FSA) options.
- Paid Time Off (PTO): Accrual-based, increases with tenure, eligible at 90 days of employment.
- Full-time new employees will receive up to 12 PTO days annually; accrual based on start date and may include additional PTO based on role and/or state & local requirements.
- Paid Holidays: Full-time employees are eligible for 10 company-paid holidays annually, in addition to 1 mental health day, 2 floating holidays and 1 volunteer day.
- Paid leave programs, including parental, bereavement, jury duty, and military leave.
- Tuition assistance (up to $5,250 annually; 80% covered by ACG).
- Professional certification support with 100% reimbursement for eligible programs.
- Opportunities for career development and advancement.
- Complimentary AAA membership with roadside assistance and travel discounts.
- Adoption assistance program.