Sr. Michigan Large Loss Homeowner Claims Field Specialist

Auto Club Group • Auburn Hills, MI

2d • $76,000 - $90,000 • Remote

About The Position

This role reports to the Meemic Insurance sector of AAA Auto-Club Group. Eligible candidates must reside within the state of Michigan for consideration and have a valid state driver's license. Sr. Michigan Large Loss Homeowner Claims Field Specialist– AAA The Auto Club Group Reports To: Claim Manager as appropriate What you will do: Work under less supervision with a high-level of authority to handle highly complex technical issues and the most complex claims. 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, and initiating documentation in the claim handling system. Complete coverage analysis on the most complex claims. 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. Senior Claims Specialist assigned to the Homeowner/CAT claim unit handle claims valued over $100,000, the insured property is unlivable and total losses. Investigate claims requiring a high level of coverage analysis and the potential assistance of experts, engineers, or specialized vendors. Substantial knowledge of building materials, construction, and restoration practices. Must be capable to independently scope and preparing large restoration estimates using available investigative and estimation tools. The ability to review contractor estimates. Requires expert negotiation skills. Strong communication skills and the ability to handle property claims that involve adverse third parties, litigation, and the use of alternative dispute resolution. Expert at provide oversight of all assigned claims including member communication, resource (including experts) coordination, tracking project schedules throughout the restoration process. May assist Claim Manager with file reviews and training.

Requirements

• 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.
• Must have a valid State Driver's License
• Five years of experience in the following:
• Negotiation of complex claim settlements
• Securing and evaluating evidence
• Preparing manual and electronic estimates
• Subrogation claims
• Resolving complex coverage questions
• Taking statements
• Establishing clear evaluation and resolution plans for claims
• Advanced technical knowledge of Essential Insurance Act (Michigan)
• Fair Trade Practices Act as it relates to claims
• Subrogation procedures and processes
• Intercompany arbitration
• Litigation
• Building construction and repair techniques
• Lift up to 25 pounds
• Climb ladders
• Walk on roofs
• 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 claim file review and investigations
• Demonstrate effective communication skills (verbal and written)
• Demonstrate 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 in order to attend meetings off site
• Work evenings or weekends

Nice To Haves

• Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
• Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent
• CPCU coursework or designation
• Xactware Training

Responsibilities

• 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 coverage analysis on the most complex claims
• Ensure all possible policyholder benefits are identified
• Create additional sub-claims if needed
• Complete an investigation of the facts regarding the claim
• Conduct thorough reviews of damages
• Evaluate the financial value of the loss
• Approve payments for the appropriate parties accordingly
• Refer claims to other company units when necessary
• Thoroughly document and/or code the claim file
• Complete all claim closure and related activities in the assigned claims management system
• Utilize strong negotiating skills
• Investigate claims requiring a high level of coverage analysis and the potential assistance of experts, engineers, or specialized vendors
• Independently scope and preparing large restoration estimates using available investigative and estimation tools
• Review contractor estimates
• Provide oversight of all assigned claims including member communication, resource (including experts) coordination, tracking project schedules throughout the restoration process
• Assist Claim Manager with file reviews and training

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree