PIP Claims Representative II – Florida

What you will do:

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The Auto Club Group is seeking prospective Claim Representative II who can work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements and establish clear evaluation and resolution plans for claims. The Auto Club Group’s PIP department is growing rapidly and is interested in all candidates with any type of PIP experience.

 

In this Claim Representative II position, you will have the opportunity to:

  • Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system.
  • Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss.
  • Ensure all possible policyholder benefits are identified, create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler.
  • Complete 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.
  • Approve 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.

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

 

How you will benefit:

PIP Claim Representative II will earn a competitive salary of $59,000 to $65,000 annually; with annual bonus potential based on performance.

  • 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:

  • Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
  • Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
  • An Adjuster’s license in the State of Florida is required for this role
  • Must have a valid State Driver’s License

 

Experience:

The ideal candidate will have experience in, at least, one of the below skill sets:

  • Two or more years of Personal Injury Protection benefits experience
  • Negotiating claim settlements
  • Securing and evaluating evidence
  • Subrogation claims
  • Resolving coverage questions
  • Taking statements
  • Establishing clear evaluation and resolution plans for claims
  • Medical management
  • Interpreting policy language
  • Florida statute knowledge
  • Letter writing

 

Required 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 insureds/claimants while exhibiting an 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
  • Research analyze and interpret subrogation laws in various states
  • Work evenings or weekends
  • Strong negotiating skills
  • Must reside in the State of Florida (Tampa Area only)

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