Catastrophe Field Claims Specialist

Key Responsibilities

• Reviewing assigned claims
• Contacting the insured and other affected parties
• Setting expectations for the remainder of the claim process, and 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
• Evaluating the financial value of the loss
• Acknowledging 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 documenting and/or coding the claim file and completing all claim closure and related activities in the assigned claims management system
• Utilizing strong negotiating skills
• Claim Specialists assigned to Homeowner/CAT claim unit handle claims valued over $25,000 (for the inside desk role) and over $100,000 (for field role)
• Investigating claims requiring in-depth coverage analysis
• When handling claims in the field, must prepare damage estimates using claims software
• Review estimates for accuracy
• May monitor contractor repair status
• May assist Claim Manager with file reviews and training

Qualifications

• Required Education: 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 states.
• Must have a valid State Driver's License
• Experience: Three years of experience or equivalent training in the following: Negotiation of claim settlements, Securing and evaluating evidence, Preparing manual and electronic estimates, Subrogation claims, Resolving coverage questions, Taking statements, Establishing clear evaluation and resolution plans for claims
• Knowledge And Skills: 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, Building construction and repair techniques
• Ability To: 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 insureds/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