Claims Manager II
The Auto Club Group (ACG) provides membership, travel, insurance and financial services offerings to approximately 9 million members and customers across 11 states and 2 U.S. territories through the AAA, Meemic and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
- Manages the daily operations and administers policies and procedures for assigned claim functions within a highly complex claim processing area.
- Performs specialized claims functions within assigned region such as organizing and managing claim investigation programs to identify fraudulent insurance claims, handling catastrophic losses/regional claims, casualty claims, subrogation, casualty litigation, etc.
- Oversees employees job responsibilities to ensure guidelines are being met and first party personal injury protection benefits are being reviewed and handled fairly and accurately.
- Manages the investigation, evaluation and settlement of complex or high dollar value claims.
- Manages personnel within assigned area.
- Interviews job applicants and recommends the hiring of personnel.
- Evaluates employee work performance.
- Counsels, disciplines and recommends the termination of subordinates as indicated.
- May be responsible for setting and developing a strategy for department operations.
- Analyzes and appraises departmental operating results and develops innovative approaches to improve performance or resolve problems.
- Conducts technical research and develops methods to reduce or contain costs related to operating expenses and paid claims.
Directly and indirectly manages a staff of management, professional, technical and or support staff who may be assigned to one or more locations.
Completion of the I.I.A. (Insurance Institute of America) or other insurance coursework.
Possession or completion of one or more of the following:
- College level coursework in Business Administration or Criminal Justice
- Chartered Property Casualty Underwriting coursework
- American Education Institute coursework or certification in insurance
- Fraud Claim Law Specialist Certification
- Certified Insurance Fraud Investigator Certification
Basic PC skills.
Previous management or supervisory experience.
Experience in one or more of the following:
- investigating fraudulent insurance claims in a multi-state environment
- handling first party personal injury protection claims involving catastrophic injuries
Knowledge of one or more of the following:
- Company fraud prosecution policies and procedures
- criminal law
- investigative practices and methods
- Company claim policies and procedures
Works in a temperature controlled office environment. Occasional travel required (25% of work time) to perform claim reinspections and attend management meetings with exposure to road hazards and temperature extremes.
Required Qualifications (these are the minimum requirements to qualify)
- College level coursework in Business Administration, Insurance, or a related field or the equivalent in related work experience. Bachelor’s degree preferred.
- 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.
- Possession of a valid State driver’s license
- policy provisions, principles, and concepts related to all phases of Homeowners claim handling
- handling large homeowner losses
- resolving complex or catastrophic injury claims
- resolving pre-litigation claims
- handling claims in a multi-state environment
- handling reinsurance functions
- managing external fraud investigations
- processing of subrogation
- administrative investigation/management experience in a private or public institution
- subrogation management
Experience to include :
- PC software applications (e.g. Microsoft Word, Excel, PowerPoint, Access)
- computer literacy and use of applicable software
Knowledge and Skills:
- claims processing policies and procedures including settlement techniques (homeowners/auto/casualty/subrogation)
- policy coverage terminology
- Fair Trade Practice Act as it relates to claims
- indications of potential fraudulent activities
- home construction/repair, product and labor costs, and alternative methods of repair
- investigation and negotiation techniques
- catastrophic personal injuries and related rehabilitation therapy required
- organizations, services and facilities providing assistance and treatment to injury claims
- subrogation procedures (all states)
- intercompany arbitration and litigation management
Management ability to include:
- strategic planning
- analyzing and problem solving
- organization and planning
- budget preparation
- decision making
- team building
- prepare and present activity reports and statistics
- manage recovery personnel and processes
- communicate effectively with others in a work and team environment
- communicate effectively with the public, law enforcement personnel and representatives of other insurance companies
- compile claim statistics
- recommend actions based on fraud investigation cases
- prepare and present written and oral reports to all levels of management
- coordinate activities of team members
- research, analyze and interpret subrogation laws in various states
- negotiate and settle complex claims
- balance workloads and assignments
- work under pressure
- strong written and oral communication skills
- work long and irregular hours.
The Auto Club Group offers a competitive compensation and benefits package including a base salary with performance based incentives; medical/dental/vision insurance, pension, 401(k), generous time off, a complimentary AAA Membership and much more!
Important Note: The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.
The Auto Club Group, and all of its affiliated companies, is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.