Claim Representative Trainee (PIP)

About the position The PIP Claims Representative Trainee, under supervision of a designated job coach and/or Claim Manager, is required to successfully complete the company’s Claims training program within 12 months. The trainee will be required to learn the fundamentals of insurance claims processing, from initial submission to settlement. The trainee must attend and focus on developing analytical, communication, and customer service skills to assist in assessing and documenting claims accurately. Through claims training and hands-on experience, the trainee will become proficient in understanding insurance policy, evaluating coverage, conducting investigations, and delivering quality service to become a Claims Representative.

Responsibilities

• Assist in processing and filing routine claims.
• Learn and properly apply the fundamentals of claims policies and procedures.
• Gather necessary documentation for claim evaluation.
• Communicate effectively with policyholders, beneficiaries, and service providers.
• Process various types of claims, including, payment approvals.
• Review and analyze claim details to determine coverage, liability, and possible fraud and/or subrogation.
• Process a claim diary and manage claim backlog.
• Investigate problems or unfinished files and complete files as needed.
• Refer files as appropriate.
• Learn to review the status of open and closed reserves and make changes consistent with exposure.
• Document claims information accurately, maintain organized records and perform claim support activity when needed.

Requirements

• High School Diploma or equivalent
• 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.
• A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members
• Knowledge of Telephone etiquette
• Basic math calculations to include addition, subtraction, multiplication, division, and percentages
• Computer application knowledge
• Learn, follow, adapt to and apply ACG Claim policies, procedures and guidelines
• Accurately document through data entry to ensure proper claims processing
• Acquire the skills to operate the assigned ACG Claim systems
• Efficiently communicate through both writing and speaking with policyholders and colleagues in the workplace
• Demonstrate customer service skills by showing empathy to enhance the customer experience.
• Collect, analyze, interpret data, and solve problems while demonstrating strong decision-making skills with colleagues.
• Demonstrate basic PC software skills (Microsoft applications.)
• Prioritize to claim-related tasks, manage time effectively, organize tasks, and plan with efficiency.
• Perform basic mathematical calculations.
• Understand basic construction methods and applications.
• Analyze claim-related data with high proficiency

Nice-to-haves

• Associate’s degree in Business Administration, Insurance, or a related field and/or equivalent coursework and experience
• IIA or CPCU coursework or designation
• Bachelor’s degree in Business Administration, Insurance or a related field
• Working in a claims or similar customer service environment
• Dealing with claims, including administrative support tasks
• Preparing repair estimates or appraisals
• Working independently in a virtual environment
• Claims operations and handling procedures
• Claims terminology and processing systems
• Insurance policy provision
• Bi-lingual (Spanish and/or Arabic) language skills
• Basic understanding of construction and building terminology
• Knowledge of Medical terminology
• Knowledge of Telephone etiquette
• Knowledge of Basic math calculations to include addition, subtraction, multiplication, division, and percentage

Benefits

• A competitive hourly salary of $26.00 with annual bonus potential based on performance
• Medical, dental and vision benefits
• 401k Match
• Paid parental leave and adoption assistance
• Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
• Paid volunteer day annually
• Tuition assistance program, professional certification reimbursement program and other professional development opportunities
• AAA Membership Discounts, perks, rewards, and much more

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