Regional APD Claim Representative II

Job Description

It’s a great time to join AAA The Auto Club Group! JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD.

Job Type: Full time

Salary: $54,643.68 - $78,000 annually, with annual bonus potential.

*** 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.***

We seek an Auto Claim Representative II who works 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.

• Review assigned claims, contact the insured and other affected parties, set expectations, and initiate 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 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.

• Handle moderately complex claims involving settling Total Losses, inspecting vehicles, and preparing estimates of damage.
• For DRS Examiner role, manage Direct Repair Shops for compliance with the program.
• Determine cause of damage, establish liability, identify subrogation potential, monitor repairs, and approve car rental expense.
• May handle simple APD Litigation cases.

None

Claim Representative II will earn a salary of $54,643.68 – $78,000 annually with potential annual bonus based on performance. Comprehensive benefits include 401k Match, Medical, Dental, Vision, PTO, Paid Holidays, Tuition Reimbursement.

• 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.

• One year of experience negotiating claim settlements, securing and evaluating evidence, preparing manual and electronic estimates, subrogation claims (including identifying recovery opportunities).
• Resolving coverage questions, taking statements, and establishing clear evaluation and resolution plans for claims.

• Essential Insurance Act (Michigan), Fair Trade Practices Act as it relates to claims, subrogation procedures and processes, intercompany arbitration/dispute resolution, negligence laws and statutes, No-Fault Law and No-Fault Reform, Collision repair techniques.
• Ability to handle claims to the line Claim Handling Standards and 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) and 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 for inspections, visits, etc. Research, analyze and interpret subrogation laws in various states.
• Travel outside of assigned territory which may involve overnight stay; relocate, work evenings or weekends; strong negotiating skills.

• Associate degree in Business Administration, Insurance or a related field or the equivalent in related work…