Michigan Claim Analyst

It's a great time to join AAA The Auto Club Group!

JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD

Job Type:

Job Description:

Position Description

Will earn a competitive hourly rate of $20.73-$28.00 with annual bonus potential based on performance.

***This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.

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

Post for All Areas:

Use Web Based and other applications to bill, document or analyze work. Refer callers to appropriate individuals for additional information as needed. May represent company at trials, depositions and settlement hearings.

Post for Claims Reinsurance:

Perform billing functions to the MCCA. Ensure all requests for reimbursements are submitted timely and accurately to the MCCA. Review all claims that were not submitted through the automatic submission for potential errors and completion of the corrections. Identify and correct incorrect benefit types, duplicate payments, subrogation issues and refunds. Ensure that claims are balanced using financial reports to ensure funds are received and exceptions are placed in a diary system that must be monitored every 30 days. Work as a liaison between our reinsurer and the claim representatives in the field to ensure all funds are recovered.

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

Experience:

• Claim analysis, or similar function

• Medical bill review (cost containment) operating a personal computer

• Utilizing software packages (e.g. Word, Excel, Access, Power Point, VISIO, etc.)

Knowledge and Skills:

Knowledge of one or more of the following:

• Medical terminology and human anatomy

• CPT, ICD-9 and 10 and revenue codes (MBRU)

• Property and casualty claims process and procedures

• FACTS, IPM, CPS and PCMS

• MMS (MCCA Membership System)

Ability to:

• Use automated processing systems

• Effectively respond to questions/concerns

• Communicate effectively with others in a work environment, with the Public and vendors

• Independently perform detailed, complex medical bill or similar analysis

Demonstrated skill in:

• Organization and planning

• Analyzing and problem solving

• Written communications to include record keeping and report preparation

• Decision making

• Negotiating

Preferred Qualifications

Education:

• Associate's degree in Business Administration, Insurance or a related field.

• Professional Coder Certification (CPT) for MBRU function

• Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent

• CPCU coursework or designation

Experience:

• Significant medical bill analysis experience

Knowledge of:

• Negligence Law

• No-Fault Law

• Essential Insurance Act

• Fair Trade Practices Act as they relate to claims

• Auto Insurance Policy contract and coverages

Work Environment

This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.

Who We Are

Become a part of something bigger.

The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.

By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance.

And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other.

We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.

To learn more about AAA The Auto Club Group visit www.aaa.com