North Carolina/ South Carolina Licensed Claim Representative I

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Job Type:

Full time

 

Exempt/Non Exempt:

 

Hourly

Job Description:

 

Reports to (job title):

Claim Supervisor or Manager as appropriate

Position Description

Will earn a competitive hourly rate $23.61- $28.00 with annual bonus potential based on performance. ***This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.***

Handle low complexity claims under close supervision and with a lower-level of claim-handling authority.  Claim handling responsibilities may cover most of the lifecycle of the claim or focus on an expanded role with specific phases such as subrogation. 

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, and initiating documentation in the claim handling system.   Complete a general coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss. Ensure all possible policyholder benefits are identified, create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler.  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.  Make referrals 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. 

Quick Claim – Auto

Employees assigned to Quick Claim will handle low complexity auto claims. Handles first party auto physical damage claims in all markets  and  must possess a strong understanding of state to state tort laws to handle claims in multiple jurisdictions across ACG footprint. Additional responsibilities may include the following: identifying and referring injuries that require reassignment of the claim; contacting the insured to verify and gather accident and damage facts to determine the appropriate method of inspecting the vehicle; reviewing vehicle repair estimates to understand the value of damages applicable to the claim;  monitoring and approving car rental expenses; monitoring vehicle repair status and interacting with DRS shops and Claims DRS Examiners when needed to resolve and communicate claim status and issues.   May serve as duty adjusters on a rotational basis to include conducting follow-up claim handling inquiries and activities for any colleague out of office (e.g., customer inquiries, issuing payments and responding to and approving car rental extensions). Identify time-sensitive tasks (e.g., diary management, subrogation, car rental, etc.) that require immediate response and take action for any colleague out of office.  Additional responsibilities include assigning and reassigning claims to ensure effective workload distribution.

Supervisory Responsibilities (briefly describe, if applicable, or indicate None):

None

Required Qualifications (these are the minimum requirements to qualify)

Education (include minimum education and any licensing/certifications):

• 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

Experience:

• negotiating claim settlements

• securing and evaluating evidence

• preparing manual and electronic estimates

Knowledge and Skills:

Basic knowledge of:

• Fair Trade Practices Act as it relates to claims

• subrogation procedures and processes

• intercompany arbitration/dispute