Michigan Claim Customer Service Representative

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Full time

Hourly

Eligible candidates must live within 50 miles of Dearborn, Michigan for consideration.

Claim Manager as appropriate

• 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 initiates 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.

None

• A competitive hourly salary between $19.00 - $22.00
• ACG offers excellent and comprehensive benefits packages, including:
• 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

• 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

• Claim processing policy and procedures
• General claim processing functions
• Claim processing systems
• Telephone etiquette

• Strong interpersonal skills demonstrated through work experience, participation in extra-curricular activities and/or community involvement
• Strong communication skills required in understanding customers' concerns and to provide high quality customer service as demonstrated through the effective use of the customer care call center model
• Effective listening skills

• Policy analysis and coverage application
• Claim payment coding, issuance, and exception handling
• Proactive customer contact and issue resolution
• Car rental coverage knowledge
• Claims' related policies and procedures
• Auto and home repair estimate basics and compliance review
• State compliance requirements
• Subrogation identification and referral (e.g. MI liability basics regarding uninsured motorists)
• Understand insurance fraud scenarios and recognize potential fraud indicators
• Issue written correspondence
• Prioritize claims-related functions
• Successfully complete at least one of the following within 9 months of hire:
  • AAA general claim policy training.
  • Policy, negligence and no-fault training
• Work independently
• Work under pressure
• Record and maintain information accurately and in a timely fashion
• Work effectively in a team environment
• Sit for the majority of the workday
• Willingness and ability to work irregular shifts, including weekends and holidays.

• Associate's…