Florida Claim Customer Service Representative

Claim Customer Service Representative – The Auto Club Group

Reports To: Claim Supervisor

What you will do:

The Auto Club Group is seeking a Florida Claim Customer Service Representative who will be responsible for taking first notice of loss, handling claim inquiries, initiating claim services and handling low-complexity, one-touch claims in a call center environment.

In this position, you will have the opportunity to:

• Identify non-complex claims for one-touch claim adjudication upon intake.

• Determine the type and extent of loss and ensures the claim is consistent with all reported facts.

• Review necessary legal and police/fire reports to process claims as necessary.

• Interpret policy language and applies coverage to authorize or deny claims.

• Initiate services, authorizes, and resolve issues related to services such as car rental and vehicle repairs and non-complex homeowner claims (e.g., food spoilage).

• Initiate and create payments, settles, or recommend settlement value of claims within specified limits.

• Identify additional claim exposures and create sub-claims as necessary.

• Refer files for investigation as warranted.

• Inform insured of coverage decision on claims within defined scope.

• Respond to claimant inquiries and explains payments.

• Document claim files.

• Review the status of open and closed reserves and makes adjustments consistent with exposures.

• Identify claims for salvage and subrogation potential in accordance to company policy.

• Close claims in a timely manner.

• Ensure compliance with state regulations.

• Handles inbound claim inquiries received via phone, the ACG website and other sources.

• Explain the benefits of company programs to customers, and initiates services, such as arranging for repair inspections, vehicle tows and car rental.

• Provide basic information to members regarding claims procedures in accordance with Customer Interaction Model.

• Promote customer satisfaction and provide seamless service to ensure customer service goals and standards are met.

• Navigate through various sources of information and claim processing systems (E.g., FACTS, CPS, Point of Sale, IPM insurance systems, Intranet/Internet, and manuals).

• Respond to members/customers questions in a timely manner.

With our powerful brand and the mentoring, we offer, you will find your position as a FloridaClaim Customer Service Representative can lead to a rewarding career at our growing organization.

How you will benefit:

• Our Auto Club Group Claim Customer Service Representative earns a competitive hourly rate of $20.28 - $ 23.00 to start along with the opportunity for an annual company bonus incentive.

• Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include:

• 401k Match

• Medical

• Dental

• Vision

• PTO

• Paid Holidays

• Tuition Reimbursement

We’re looking for candidates who: (Preferred/Required Qualifications)

Education (include minimum education and any licensing/certifications):

• High School Diploma or equivalent

• Completion of AAA approved call center training program, appropriate level ACG Claim Representative Training program and ongoing training and certification for the position

• Must have an active Florida State Adjuster License

Experience:

• Processing information and handling claim inquiries utilizing PCs and software packages (e.g. ACG claim systems, Microsoft Word, Excel)

• Reading and comprehending various Customer Care service tools (manuals, work models, etc.)

• Performing mathematical calculations including adding, subtracting, percentages, etc.

• Analyzing and resolving problems

• A claim related field such as insurance, automotive, medical or legal services

• A call center environment

• Utilizing ACG automated systems

• Investigating and resolving claims related problems

• Handling claims or claim support tasks such as processing glass claims, car rentals, invoice payments, etc.

Knowledge and Skills:

Knowledge of:

• Claim processing policy and procedures

• General claim processing functions

• Claim processing systems

• Telephone etiquette

• ACG insurance processes and procedures

• Auto and home repair basics and cost estimating

• State insurance laws

• Regulatory compliance requirements

• Property and casualty insurance policy language and provisions

• Claims quality service standards

• Liability, negligence, No-Fault principles and subrogation

Ability to provide a high level of customer service:

• Strong interpersonal skills demonstrated through work experience, participation in extra-curricular activities and/or community involvement

• Strong communication skills required in understanding customers’ concerns and to provide high-quality customer service as demonstrated through the effective use of the customer care call center model

• Excellent verbal communication skills service

• Strong written communications skills (example may be required at time of interview) needed to respond in a professional manner to members/customers inquiries

• Effective listening skills

Ability to learn and apply claim handling skills, including:

• Policy analysis and coverage application

• Claim payment coding, issuance, and exception handling

• Proactive customer contact and issue resolution

• Car rental coverage knowledge

• Claims’ related policies and procedures

• Auto and home repair estimate basics and compliance review

• State compliance requirements

• Subrogation identification and referral

• Understand insurance fraud scenarios and recognize potential fraud indicators

• Issue written correspondence

• Prioritize claims-related functions

Ability to:

• Successfully complete at least one of the following within 9 months of hire:

• AAA general claim policy training.

• Policy, negligence, and no-fault training

• Proactively contact and effectively interact with the public and business partners through outbound communication

• Work independently

• Communicate effectively over the telephone

• Work under pressure

• Record and maintain information accurately and in a timely fashion

• Work effectively in a team environment

• Sit for the majority of the workday

• Willingness and ability to work irregular shifts, including weekends and holidays

• Must reside within 50 miles from our Tampa Florida Location

Work Environment

This is a hybrid work arrangement (time spent in office and remote). Depending on the employee's role and leadership's assessment, some employees will come into an ACG facility on a weekly basis, a monthly basis, or on an "as needed" basis for key meetings and collaborative activities. Most employees will be required to come into the office, at a minimum, for important departmental meetings or teambuilding events.