Claims Service Representative 3

3 weeks ago

Long Beach, United States Automobile Club of Southern California Full time
Claims Service Representative 3 - Medpay

This position handles moderate to higher complexity claims matters involving material damage, 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 moderate to higher complexity claims. Employs discretion and independent judgment to ensure compliance with state and federal law, and with established company, technical, and customer service best practices.

Responsibilities:

  • 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. 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.

  • 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 first- and third-party claims.

  • Update database production reports, and document and update claim files via company systems, i.e. CACS, HUON, HOC, etc.

  • Control expenses for areas of responsibility.

  • 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.

Education:

  • Four-year college degree or equivalent combination of education and experience required.

  • Evidence of continuing education (i.e. industry designations) preferred.

Knowledge/Skills/Ability:

  • Ability to service claims of low, moderate, and higher complexity as normally acquired through 5-15 years’ experience. Multi line business experience desirable.

  • Advanced understanding of: Vehicle repair procedures and issues or - Building repair procedures and issues or - Third party liability issues.

  • Moderate computer and line of business technical software skills required.

  • Moderate knowledge of fault assessment and subrogation principles required.

  • Moderate leadership competencies necessary.

  • Advanced organization and planning recognition skills required.

  • Advanced oral and written communication skills required.

  • Advanced interpersonal skills required.

Special:  Valid driver license with level of financial responsibility required by the Club and an acceptable motor vehicle record required for the field positions.

The starting pay range for this position is:

$34.14 - $45.52

Additionally, you will be eligible to participate in our incentive program based upon the achievement of organization, team and personal performance.

.

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

Auto Club Enterprises is the largest federation of AAA clubs in the nation. We have 14,000 employees in 21 states helping 17 million members. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering legendary, lifetime service to our members. When we embrace our diversity – we win. All of Us With our national brand recognition, long-standing reputation since 1902, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

“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

The Automobile Club of Southern California will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance.

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