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Claims Service Representative III
2 months ago
Claims Service Representative III - Casualty
This 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 and Job Duties:
- 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.
- Provide independent analysis and differentiation between allegations and facts.
- Determine policy obligations by assessing the liability and damage components of the loss.
- Independently resolve claim exposures within level of authority.
- Respond quickly to customer needs and problems.
- Recognize and appropriately address common coverage issues.
- Recognize and appropriately address common subrogation issues.
- 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' bodily injury experience preferred.
Knowledge/Skills/Competencies:
- 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.
The starting pay range for this position is:
$34.14 - $45.52
Additionally, for full time positions, 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.
