Catastrophe Field Claim Specialist Job Chicago area,Illinois USA,Insurance

Resolving coverage questions
Essential Insurance Act (Michigan)
Prescription drug coverage.

Job Type:

Full time

Exempt/Non Exempt:

Salary

Job Description:

Location Details:

Detroit, Michigan

Chicago, Illinois

Position Schedule /

Shift:

Hybrid– Field schedule Monday – Friday: 8:30 AM EST – 5:30 PM EST. Some weekend hours may be required based on work assignments.

Position Summary:

Make a meaningful impact when people need it most. As a Catastrophe Field Claims Specialist, you'll be on the front lines helping customers recover after catastrophic events by conducting on-site inspections, evaluating damage, and guiding them through the claims process. This dynamic role combines problem-solving, relationship-building, and travel, offering the opportunity to deliver exceptional service while helping communities rebuild and move forward.

Key Responsibilities:

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
Claim Specialists assigned to Homeowner/CAT claim unit handle claims valued over $25,000 (for the inside desk role) and over $100,000 (for field role)
Investigate claims requiring in-depth coverage analysis
When handling claims in the field, must prepare damage estimates using claims software
Review estimates for accuracy
May monitor contractor repair status
May assist Claim Manager with file reviews and training

Qualifications:

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.
Must have a valid State Driver's License

Experience:

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

Knowledge And

Skills:

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
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
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…