North Carolina Claim Customer Service Rep-1

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Job Type:

Job Description:

Position Description

Will earn a competitive hourly rate of $18.74-$28.00 with annual bonus potential based on performance.

***This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.***

Handle low complexity claims under close supervision and with a lower-level of claim-handling authority. Claim handling responsibilities may cover most of the lifecycle of the claim or focus on an expanded role with specific phases such as subrogation.

Primary Duties and Responsibilities (details of the basic job functions):

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. Documents claim files. Reviews the status of open and closed reserves and makes adjustments consistent with exposures. Identify claims for salvage and subrogation potential in accordance to company policy. Closes claims in a timely manner. Ensure compliance with state regulations.

Completes first notice of loss (FNOL) 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 initiates 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 (briefly describe, if applicable, or indicate None):

None

Required Qualifications (these are the minimum requirements to qualify)

Education (include minimum education and any licensing/certifications):

• 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 and Skills:

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

• excellent verbal communication skills service

• strong written communications skills (example may be required at time of interview) needed to respond in a professional manner to members/customers inquiries

• 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

• claims' related policies and procedures

• auto and home repair estimate basics and compliance review

• state compliance requirements

• subrogation identification and referral (e.g. MI liability basics regarding uninsured motorists)

• understand insurance fraud scenarios and recognize potential fraud indicators

• issue written correspondence

• prioritize claims-related functions

Ability to:

• successfully complete at least one of the following within 9 months of hire:

  • AAA general claim policy training;

  • policy, negligence and no-fault training

• proactively contact and effectively interact with the public and business partners through outbound communication

• work independently

• communicate effectively over the telephone

• work under pressure

• record and maintain information accurately and in a timely fashion

• work effectively in a team environment

• sit for the majority of the work day

• willingness and ability to work irregular shifts, including weekends and holidays.

• willingness to relocate

Preferred Qualifications

Education:

• Associate's degree in Business Administration or a related field, or the equivalent in related work experience.

• Completion of (IIA) Insurance Institute of America or other insurance coursework.

Experience to include:

• Bilingual - Spanish
• Adjuster License in North/ South Carolina or reciprocal state for adjuster license

• a claim related field such as insurance, automotive, medical or legal services

• a call center environment

• utilizing ACG automated systems

• investigating and resolving claims related problems

• handling claims or claim support tasks such as processing glass claims, car rentals, invoice payments, etc.

Knowledge of:

• ACG insurance processes and procedures

• auto and home repair basics and cost estimating

• State insurance laws

• regulatory compliance requirements

• property and casualty insurance policy language and provisions

• claims quality service standards

• liability, negligence, No-Fault principles and subrogation

Work Environment

Work in a temperature-controlled office environment. Willingness and ability to work irregular shifts, including weekends and holidays. Willingness to relocate.

Who We Are

Become a part of something bigger.

The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.

By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance.

And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other.

We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.

To learn more about AAA The Auto Club Group visit www.aaa.com