APD Claim Representative - Meemic

Job Type: Full time Exempt/Non Exempt:
Hourly

Job Description:

Location Details:
Remote

Position Schedule / Shift: Monday-Friday 9am-6pm ET

Position Summary:

As an Auto Claim Representative I, you will be responsible for investigating, evaluating, and resolving low complexity automobile physical damage claims in accordance with company policies and applicable regulations. Reviews claim information, assesses vehicle damage, determines coverage, and coordinates repairs or settlements.

• 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 process
• 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.

• Employees assigned to Auto Physical Damage (“APD”) claim unit will handle moderately complex claims involving settling Total Losses, inspecting vehicles and preparing estimates of damage.
• If in the DRS Examiner role, manage Direct Repair Shops for compliance with our program.
• Determine cause of damage, establishing liability, identifying subrogation potential, monitoring repairs and approving car rental expense.
• May handle simple APD Litigation cases.

Required Education (including minimum education and any licensing/certifications):
High school diploma or equivalent 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 state

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:

Six months of experience or equivalent training in the following: negotiation of claim settlements securing and evaluating evidence preparing manual and electronic estimates subrogation claims-identifying recovery opportunities

Knowledge of:
Advanced knowledge of:
Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims subrogation procedures and processes intercompany arbitration 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 insured/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…