Michigan Claim Customer Service Representative

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Hourly

Job Description:

Attendance is mandatory during the initial 90-day training and probationary period for this position. New hires are expected to be present for all scheduled training sessions. Absences, tardiness, or early departures during this period may impact continued employment. Candidates should ensure they are able to meet these attendance expectations before applying for consideration. Eligible candidates must also live within 50 miles of Dearborn, Michigan for consideration.

Michigan Claim Customer Service Representative – AAA The Auto Club Group

Reports To:

Claim Manager as appropriate

What you will do :

Claim Customer Service Representatives will be responsible for taking first notice of loss, handling claim inquiries, initiating claim services, and handling low-complexity, one-touch claims in a call center environment.

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 initiate 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.

Supervisory Responsibilities:

None How you will benefit:

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

We’re looking for candidates who:

Education:

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).

Experience:

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

Knowledge of:

Claim processing policy and procedures

General claim processing functions

Claim processing systems

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