APD Claim Representative II - Michigan

Position Summary

As an Auto Liability Michigan Claim Representative II, you will play a pivotal role in delivering exceptional claim outcomes while making a meaningful difference in customers' lives during challenging situations. In this dynamic and fast-paced role, you will investigate, evaluate, negotiate, and resolve automobile liability claims with confidence and expertise, ensuring compliance with Michigan insurance laws, company guidelines, and regulatory requirements. Leveraging strong analytical, problem-solving, and negotiation skills, you will assess liability, gather critical facts, and drive fair, timely claim resolutions.

Key Responsibilities

• Reviewing assigned claims
• Contacting the insured and other affected parties
• Setting expectations for the remainder of the claim process
• Initiating documentation in the claim handling system
• Completing complex coverage analysis
• Ensuring all possible policyholder benefits are identified
• Create additional sub-claims if needed
• Completing an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential.
• Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
• Evaluate the financial value of the loss
• Acknowledge payments for the appropriate parties accordingly
• Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
• Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system
• Utilize strong negotiating skills.

Qualifications

• Required Education (including minimum education and any licensing/certifications): High school diploma or equivalent Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience In states where an Adjuster’s license is required, the candidate must be eligible to acquire a State Adjuster’s license within 90 days of hire and maintain as specified for appropriate state A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members
• Experience: Two years of experience or equivalent training in the following: negotiation of claim settlements securing and evaluating evidence preparing manual and electronic estimations subrogation claims - identifying recovery opportunities resolving coverage questions taking statements establishing clear evaluation and resolution plans for claims
• Knowledge of: Advanced knowledge of: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims subrogation procedures and processes intercompany arbitration handling simple litigation negligence law no-fault law collision repair techniques

Skills

• Handle claims to the line
• Claim Handling Standards
• Follow and apply ACG Claim policies, procedures and guidelines
• Work within assigned ACG Claim systems including basic PC software
• Perform basic claim file review and investigations
• Demonstrate effective communication skills (verbal and written)
• Demonstrate customer service skills by building and maintaining relationships with insured/claimants while exhibiting understanding of their problems and responding to questions and concerns
• Analyze and solve problems while demonstrating sound decision-making skills
• Prioritize claim related functions
• Process time sensitive data and information from multiple sources
• Manage time, organize and plan workload and responsibilities
• Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc.
• Research, analyze and interpret subrogation laws in various states
• Travel outside of assigned territory which may involve overnight stay
• Relocate, work evenings or weekends