Michigan Homeowners Claim Representative II – Fremont, MI

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Job Type:

Full time

 

Exempt/Non Exempt:

 

Salary

Job Description:

 

Michigan Homeowners Claim Representative II – Fremont, MI

What you will do:

The Auto Club Group is seeking prospective Homeowner Claim Representative II who can 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.

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 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.  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 the Homeowner/CAT claim unit will handle claims generally valued between $5,000 and $25,000 (for the inside desk role) and up to $100,000 (for field role). Investigate claims requiring coverage analysis. When handling claims in the field, prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status and update.

We’re looking for candidates who:

Required Qualifications (these are the minimum requirements to qualify)

Education:

• 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.

Experience:

One year of experience or equivalent training in the following:

• Negotiating 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

Knowledge and Skills:

Advance knowledge of:

• Essential Insurance Act (Michigan)

• Fair Trade Practices Act as it relates to claims

• Subrogation procedures and processes

• Intercompany arbitration

Knowledge of:

• 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 effective communication skills (verbal and written)

• 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 workload and responsibilities

• Research, analyze, and interpret subrogation la