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).
Requirements
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
Telephone etiquette
Ability to provide a high level of customer service in a professional call center environment using the following skills:
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
Ability to learn and apply claim handling skills, including:
Policy analysis and coverage application
Claim payment coding, issuance, and exception handling
Proactive customer contact and issue resolution
Car rental coverage knowledge
Benefits
Dental insuranceVision insurance401(k)Paid time offParental leave
Additional Information
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
Exempt/Non Exempt:
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
Acg · MI