- Communicate and interact with a variety of individuals including insureds and claimants. Explain benefits, coverages, fault and claims process either verbally or in writing in compliance with regulatory and statutory requirements.
- Conduct phone and/or field investigations to determine liability and damages. May attend and participate in legal proceedings. Identify and obtain statements from insureds, claimants and witnesses.
- Evaluate and determine claim values upon receipt and assessment of property, bodily injury and liability data.
- Negotiate within settlement authority with insureds and claimants to resolve their first and third party claims.
- Handle administrative functions, update database production reports, and document and update claim files via company systems, i.e. CACS, HUON, HOC, etc.
- Verify and interpret/resolve coverage by gathering necessary information to ensure policy applicability. Coordinate with internal and external departments as required.
- Identify cross-sell opportunities based on members' product needs and service requests. Enhance member relationship by diversifying use of products and services. Provide sales leads to insurance, travel and other departments as appropriate.
- Perform other duties and responsibilities as assigned or required.
- 4-yr. College Degree or equivalent combination of education and work experience required.
- Ability to service claims of low to moderate complexity, as normally acquired through 3-5 years' experience.
- Moderate computer and line of business technical software skills required.
- General knowledge of negligence and subrogation principles desired.
- Moderate understanding of vehicle nomenclature and repair practices or;
- Moderate understanding of building nomenclature and repair practices.
- Advanced organization and planning recognition skills required.
- Advanced oral and written communication skills required.
- Advanced interpersonal skills required.
- Valid driver's license with a level of financial responsibility required by the club and an acceptable motor vehicle record required for field positions.
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Claims Service Representative II - Portland, United States - Automobile Club of Southern California
Description
Claims Service Representative II - MedpayThis position supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of property and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include investigation, evaluation and negotiation of low to moderate complexity claims in compliance with established company technical and customer service Best Practices. Under general technical direction, works within specific limits of authority.
Responsibilities & Job Duties
Qualifications
Education:
Experience:
Knowledge/Skills/Competencies:
Special:
Remote work is based on manager discretion and performance. Onboarding and training will be conducted on-site at an Auto Club facility. Employees must demonstrate reliability and proficiency in the department to be considered. Employees must have adequate high-speed internet, minimum of 50 Mbps. Employees must live within a reasonable commuting distance of their assigned Claims Unit. Employees assigned to a Claims Unit are required to report to the office for coaching and training opportunities upon request.
Remarkable benefits:
• Health coverage for medical, dental, vision
• 401(K) saving plan with company match AND Pension
• Tuition assistance
• PTO for community volunteer programs
• Wellness program
• Employee discounts (membership, insurance, travel, entertainment, services and more)
"Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value."
AAA is an Equal Opportunity Employer
