Claims Service Representative III – Special Investigations Unit

Claims Service Representative III – Special Investigations Unit

This position's primary responsibility is the investigation and disposition of potentially fraudulent claims in any product line sold by the organization. The position also acts as liaison between the organization and industry entities, which include other carriers, law enforcement, District Attorneys, NICB and the Department of Insurance. The position requires a diverse skill set which includes investigating, public speaking, teaching and reporting.

The position requires a high degree of discretion and independent judgment in analysis, problem solving, and time management to effectively manage investigations.

Job Duties

• Develop and implement investigative strategies for assigned casualty, auto property damage, auto theft, and/or homeowners claims.
• Complete and/or supervise thorough field investigations to ensure proper coverage is afforded. Includes reviewing and investigating suspicious activity, using effective investigation strategies, background search, and research as appropriate.
• Prepare and provide appropriate investigative reports clearly outlining the issues, investigation, and findings/recommendations to claims staff.
• Ensure proper reporting to NICB, Department of Insurance, and local District Attorneys, as warranted. Includes attending and/or testifying in court hearings and proceedings as required.
• Remain current on emerging fraud trends, investigations, and fraud identifying/combatting tools.
• Provide training to claims staff on insurance fraud and industry trends. Liaise with assigned claims teams to educate integral anti-fraud personnel to identify, articulate, and refer suspicious claims.

Qualifications

• Bachelor's or equivalent combination of education and experience preferred
• 4-6 Year prior Claims experience required
• Moderate computer and line of business technical software skills required.
• Advanced application of policy language as applied to coverage, liability, and settlement.
• Advanced organization and planning recognition skills required.
• Advanced oral and written communication skills required.
• Advanced interpersonal skills required.
• Advanced interviewing and negotiation skills required.
• Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State required.

Remarkable benefits: • Health coverage for medical, dental, vision • 401(K) saving plan with company match AND Pension • Tuition assistance • PTO for community volunteer programs • Wellness program • Employee discounts (membership, insurance, travel, entertainment, services and more!)

Auto Club Enterprises is the largest federation of AAA clubs in the nation. We have 14,000 employees in 21 states helping 17 million members. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering legendary, lifetime service to our members. When we embrace our diversity – we win. All of Us! With our national brand recognition, long-standing reputation since 1902, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

"Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value."

AAA is an Equal Opportunity Employer