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Claim Manager II - BI Litigation

Expired Job

AAA Auto Club Dearborn , MI 48120

Posted 2 weeks ago

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.

Primary Duties and Responsibilities (details of the basic job functions):

Manages the daily operations and administers policies and procedures for assigned claim functions within a large loss or 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. 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. Schedules work hours and assigns job duties. Evaluates employee work performance. Counsels, disciplines and recommends the termination of subordinates as indicated.

Accountable for financial and non-financial results (budget and actual), project management and staff management. Prepares budget estimates and ensures adherence to budgetary guidelines. Takes necessary corrective action to mitigate or reverse unfavorable variances. Reviews and approves reserves for both general and catastrophic claims. Facilitates and supports departmental objectives.

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. Prepares statistical forms necessary to produce monthly company financial reports.

Works in cooperation with director to develop contingency planning for large scale catastrophic losses.

Conducts technical research and develops methods to reduce or contain costs related to operating expenses and paid claims.

Provides direct assistance to director and executive staff in coordinating or conducting special claim surveys and projects.

Involved with outside organizations in the community to enhance public image.

Performs claim investigation and settlement activities in catastrophic loss/injury situations as warranted. Coordinates the investigation of suspected fraud at branches and other office locations.

Supervisory Responsibilities (briefly describe, if applicable, or indicate None):

Directly and indirectly manages a staff of management, professional, technical and or support staff who may be assigned to one or more locations.

Preferred Qualifications:

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

  • Ameircan 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

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

Work Environment:

Works in a temperature controlled office environment. Occasional travel required (20% 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):

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

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

Experience:

Claims management experience to include :

  • 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 :

  • participating in the design and implementation of medium to large projects
  • project planning and management
  • PC software applications (e.g. Microsoft Word, Excel, PowerPoint, Access)
  • computer literacy and use of applicable software

Knowledge and Skills:

Knowledge to include one or more of the following*

  • 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

  • homeowner loss prevention techniques

  • catastrophic personal injuries and related rehabilitation therapy required

  • organizations, services and facilities providing assistance and treatment to injury claims

  • subrogation procedures (all states)

  • auto physical damage and/or casualty claim handling

  • intercompany arbitration and litigation management

Management ability to include:

  • strategic planning
  • analyzing and problem solving
  • organization and planning
  • budget preparation
  • decision making
  • leadership
  • team building

Ability to:

  • 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

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.


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Claim Manager II - BI Litigation

Expired Job

AAA Auto Club