About this role
Role Overview
- 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).
Requirements
- 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).
- Experience: 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
Benefits
- A competitive hourly salary between $19.00
- $22.00
- 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