Claim Representative II

This is a fully remote position, open to applicants in Michigan.

📋 Description

• Assess assigned automobile liability and auto physical damage claims.

• Communicate with insured individuals and other impacted parties to set expectations for the claims process.

• Initiate and manage claim documentation within the claims handling system.

• Conduct thorough coverage analysis to identify all applicable policyholder benefits.

• Create additional sub-claims when necessary.

• Investigate claim details to ascertain payment amounts, applicable limits or exclusions, and recovery possibilities.

• Review damages and evaluate the relevance of Michigan state law and other claim-related factors.

• Assess the financial value of losses.

• Authorize payments to appropriate parties.

• Escalate claims to Underwriting, Recovery Units, or the Claims Special Investigation Unit as necessary.

• Document and categorize claim files, completing closure tasks in the claims management system.

• Negotiate resolutions for claims.

• Settle moderately complex auto physical damage total losses.

• Inspect vehicles and prepare damage estimates.

• Oversee Direct Repair Shops for program compliance while acting as a DRS Examiner.

• Determine the cause of damage, establish liability, identify subrogation potential, monitor repairs, and approve car rental costs.

• Manage straightforward APD litigation cases.

• Provide fair and timely claim resolutions in adherence to Michigan insurance laws, company policies, and regulatory requirements.

⛳️ Requirements

• High school diploma or equivalent qualification.

• Completion of the ACG Claim Representative Training Program or proven equivalent knowledge or experience.

• Eligible to obtain a State Adjuster’s license within 90 days of hiring, where required, and maintain it as specified.

• Valid driver's license is mandatory if responsibilities entail in-person inspections or frequent face-to-face meetings.

• Minimum one year of experience or equivalent training in negotiating claim settlements, securing and evaluating evidence, preparing manual and electronic estimates, identifying subrogation recovery opportunities, resolving coverage inquiries, taking statements, and establishing claim evaluation and resolution strategies.

• Advanced understanding of the Essential Insurance Act (Michigan), Fair Trade Practices Act related to claims, subrogation procedures, intercompany arbitration, simple litigation, Negligence Law, No-Fault Law, and collision repair methodologies.

• Capability to manage claims according to Claim Handling Standards and implement ACG Claim policies, procedures, and guidelines.

• Proficiency in navigating ACG Claim systems and basic PC software.

• Basic skills in claim file review and investigation.

• Strong verbal and written communication skills.

• Customer service and relationship-building abilities with insured individuals and claimants.

• Problem-solving, sound decision-making, prioritization, time management, organization, and workload planning capabilities.

• Ability to process time-sensitive information from various sources.

• Ability to safely drive a motor vehicle for visits to repair facilities, homes, patients, and other locations.

• Capability to research, analyze, and interpret subrogation laws across different states.

• Willingness to travel beyond the assigned territory, potentially overnight.

• Willingness to relocate and work evenings or weekends.

• Preferred: Associate degree in Business Administration, Insurance, or a related field, or equivalent relevant work experience.

• Preferred: Completion of Insurance Institute of America programs, CPCU coursework or designation, I-CAR ProLevel training, CCC training, or XACTware training.

🏝️ Benefits

• Annual company bonus incentive.

• Medical plans with various coverage options, including HSA eligibility.

• Prescription drug coverage.

• Dental and vision benefits.

• Employee Assistance Program.

• Company-funded basic life insurance.

• Optional supplemental life insurance and dependent coverage.

• Short-term and long-term disability coverage.

• Options for critical illness, accident, and pet insurance.

• 401(k) plan featuring automatic deferral, employee contributions, company matching, and additional company contributions.

• Health Savings Account (HSA) and Flexible Spending Accounts (FSA).

• Paid Time Off (PTO), which increases with tenure.

• 10 company-paid holidays each year for full-time employees.

• 1 mental health day, 2 floating holidays, and 1 volunteer day for full-time employees.

• Paid parental, bereavement, jury duty, and military leave.

• Tuition assistance of up to $5,250 annually, with 80% covered by ACG.

• Support for professional certification with 100% reimbursement for eligible programs.

• Opportunities for career development and advancement.

• Complimentary AAA membership with roadside assistance and travel discounts.

• Adoption assistance program.

• Option for remote work from a home office for daily operations, subject to ACG Flex Work policy.