Claims Service Representative 3 - Special Investigations Unit

MS ACSC Management Services Inc; Oklahoma; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health coverage

401(K) matching and Pension

Tuition assistance

Floating holidays and PTO

Paid parental leave

Wellness programs

Employee discounts

Job summary

AAA Auto Club Enterprises is seeking a Claims Service Representative III for the Special Investigations Unit to investigate potential fraud across product lines and serve as liaison with law enforcement and regulatory bodies. The role requires independent judgment, effective problem solving, and strong reporting abilities.

Responsibilities include leading field investigations, reviewing suspicious activity, and training staff on fraud trends.

Qualifications

• Bachelor's degree or equivalent and 4–6 years of claims experience are required.
• Advanced oral and written communication skills are required.
• Strong interpersonal and negotiation abilities are needed.

Responsibilities

• Develop and implement investigative strategies for assigned claims.
• Conduct thorough field investigations and ensure proper coverage.
• Prepare clear investigative reports with findings and recommendations.

Skills

Claims experience

Communication skills

Interpersonal skills

Public speaking

Education

Bachelor's degree or equivalent

Tools

Technical software

Job description

Job Summary

Claims Service Representative 3 - Special Investigations Unit Job Summary 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.

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, and background searches and research as appropriate.
• Prepare and provide appropriate investigative reports clearly outlining the issues, investigation, and findings and 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.
• The position requires a higher degree of discretion and independent judgment in analysis, problem solving, and time management to effectively manage investigations.

Qualifications

• Bachelors Equivalent combination of education and experience 4-6 years 4-6 Years prior Claims experience 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 Travel Requirements Claims field duties may involve driving and local travel to canvas scenes and interview witnesses. (20% proficiency)

Benefits

Remarkable benefits:

• Health coverage for medical, dental, vision
• 401(K) saving plans with company match AND Pension
• Tuition assistance
• Floating holidays and PTO for community volunteer programs
• Paid parental leave
• Wellness programs
• Employee discounts (membership, insurance, travel, entertainment, services and more!)

Auto Club Enterprises is the largest club within the national AAA federation. We have nearly 17,000 employees in 24 states helping more than 18 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 1900, 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

Our organization participates in E-Verify

For more than a century, AAA has been synonymous with trust, dependability, quality, and innovation. It's our mission to provide our growing membership with the legendary service we are famous for, and we welcome committed professionals ready to challenge themselves in a dynamic industry.

AAA would not exist without the millions of members who give us their loyalty, or our employees whose mission it is to give those members world-class service.

What else do we offer? Stability. Growth. Commitment to an exciting future for both you and our members.