Claims Service Representative 2 - Med Pay

This position handles moderate to higher complexity Auto claims matters involving material damage, property and / or liability lines of insurance written by the Interinsurance Exchanger 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.

Conduct phone and or filed 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 first and third-party claims.
• Update claims files via company systems, i.e. CACS, HUON, HOC, etc.
• Verify and interpret / resolve coverage's by gathering necessary information to ensure policy applicability.
• Recognize and appropriately address coverage issues.
• Recognize and appropriately address subrogation issues.
• Objectively discern and address issues that may be questioned in audit.
• Independently resolve claims within authority level.

Education :

• Four-year college degree or equivalent combination of education and experience required.
• Evidence of continuing education (i.e. industry designations) preferred.

Experience :

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

Knowledge / Skills / Competencies :

• Vehicle repair procedures and issues.
• Building repair procedures and issues.
• Third party liability issues.
• Moderate computer and line of business technical software skills required.
• Moderate knowledge of fault assessment and subrogation principles required.
• Advanced organization and planning recognition skills required.
• Advanced oral and written communication skills required.

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 (membership, insurance, travel, entertainment, services and more!)

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

Last updated : 2024-05-24