Claims Service Representative 3 - Special Investigations Unit

Job Summary

This position's primary responsibility is the investigation and disposition of potentially fraudulent claims in any product line sold by the organization. The position also acts as liaison between the organization and industry entities, which include other carriers, law enforcement, District Attorneys, NICB and the Department of Insurance.

Job Duties

• Develop and implement investigative strategies for assigned casualty, auto property damage, auto theft, and/or homeowners claims.
• Complete and/or supervise thorough field investigations to ensure proper coverage is afforded. Includes reviewing and investigating suspicious activity, using effective investigation strategies, and background searches and research as appropriate.
• Prepare and provide appropriate investigative reports clearly outlining the issues, investigation, and findings and recommendations to claims staff.
• Ensure proper reporting to NICB, Department of Insurance, and local District Attorneys, as warranted. Includes attending and/or testifying in court hearings and proceedings as required.
• Remain current on emerging fraud trends, investigations, and fraud identifying/combatting tools.
• Provide training to claims staff on insurance fraud and industry trends.
• Liaise with assigned claims teams to educate integral anti-fraud personnel to identify, articulate, and refer suspicious claims.

Qualifications

• Bachelor’s Equivalent combination of education and experience
• 4-6 years 4-6 Years prior Claims experience
• Moderate computer and line of business technical software skills required.
• Advanced application of policy language as applied to coverage, liability, and settlement.
• Advanced organization and planning recognition skills required.
• Advanced oral and written communication skills required.
• Advanced interpersonal skills required.
• Advanced interviewing and negotiation skills required.
• Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required
• Claims field duties may involve driving and local travel to canvas scenes and interview witnesses. (20% proficiency)

Remarkable Benefits

• Health coverage for medical, dental, vision
• 401(K) saving plans with company match AND Pension
• Tuition assistance
• Floating holidays and PTO for community volunteer programs
• Paid parental leave
• Wellness programs
• Employee discounts (membership, insurance, travel, entertainment, services and more!)
• Auto Club Enterprises is the largest club within the national AAA federation. We have nearly 17,000 employees in 24 states helping more than 18 million members.

Schedule

Claims field duties may involve driving and local travel to canvas scenes and interview witnesses. (20% proficiency)

Pay

Commensurate with experience