At American Family Insurance, we believe people are an organization’s most valuable asset, and their ideas and experiences matter. From our CEO to our agency force, we’re committed to growing a diverse and inclusive culture that empowers innovation that will inspire, protect, and restore our customers’ dreams in ways never imagined.

American Family Insurance is driven by our customers and employees. That’s why we provide more than just a job – we provide opportunity. Whether you’re already part of our team in search of a new challenge or new to our company and ready for what’s next, you’re in the right place. Every dream is a journey that starts with a single step. Start your journey right here. Join our team. Bring your dreams.

Job ID:

R31365 Subrogation Technician - PIP & MedPay (Open)

Compensation may vary based on the job level and your geographic work location.

Compensation Minimum:$23.00 Hourly

Compensation Maximum:$34.07 Hourly

Summary:

At American Family Insurance Claims Services (AFICS, Inc.), we’re embarking on a transformation of our claims capabilities that will put customers at the center of what we do best – protecting and restoring their dreams when they need us most.

We’re leveraging our expertise, technology and new ways of working to actively reinvent one of America’s largest industries—creating positive impact that empowers our customers, communities, and company to thrive. We are problem solvers who ask critical questions and consistently tackle challenges big and small. Together, we disrupt what’s expected of insurance.

Position Objective
The Subrogation Adjuster is responsible for maximizing subrogation recoveries cost effectively for all policy lines for simple to moderately complex files. Evaluates and resolves subrogation issues and acts as a technical resource. Is effective in promoting a climate conducive to resolving minor subrogation issues. This role will handle subrogation for low complex medical claims and will have a dotted line reporting relationship to the PIP & Med Pay subrogation teams.

Job Description:

Primary Accountabilities

Subrogation Recovery (40%)

• Understands how to present subrogation claims on behalf of the Company/insured based on file analysis for simple to moderately complex files. Prepares cases for arbitration.
• Generates communication strategies with adverse carrier or claimants and negotiates settlement recovery on simple to moderately complex subrogation claims.
• Evaluates simple to moderately complex claims presented to American Family and determines if adverse carrier/self-insured's settlement offer to American Family is acceptable, on property, physical damage, and medical reimbursement claims.
• Obtains additional investigative and damage support evidence and is able to apply information received in order to maximize recovery opportunities.
• Understands fundamental aspects of claim investigation and elements of damage for the presentation of a prima facie tort liability case for recovery on files assigned within their authority.

Analyze and Evaluate Factual Evidence and Subrogation Potential (25%)

• Recognizes potential liability exposures and has basic knowledgeable in securing data in which the file may be lacking.
• Assesses new simple to moderately complex files to determine completeness of investigation and factual evidence (e.g. scene investigations, police reports, statements). Analyzes and evaluates factual information to determine appropriate liability percentage to maximize subrogation recoveries. Handles claims involving multiple insureds/carriers, product liability, and fire losses.
• Analyzes the cost effectiveness of pursuing a subrogation claim based on potential recovery versus cost of recovery.
• Identifies, obtains opinions and discusses strength of factual evidence when appropriate from manager and/or experts.
• Exhibits basic knowledge of unfair claim practice acts, corporate claim standards, company claim bulletins and the company code of ethics. Handles claims in good faith.
• Understands and applies applicable case law and statutes, considering geographic location and local ordinances.

Securing Factual Evidence (10%)

• Determines if damages are accident/incident-related.
• Understands and is able to access multiple internal systems and software to gather necessary documentation to prove our claim.
• Demonstrates basic knowledge of when to secure additional investigative and damage support evidence to maximize subrogation recovery.

Agency Relationship (10%)

• Establishes rapport with agents and builds on-going relationships by including agents in the claim handling process as appropriate.
• Gains knowledge to identify opportunities for process improvements.
• Gains knowledge of circumstances that may affect customer service with agency, vendors, third party administrators or other claim personnel.
• Provides agents with claim handling information via phone conversations, office visits or presentations at district meetings.

Acquiring and Applying Claim Knowledge (15%)

• Develops an ability to apply legal and medical terminology, regulations and procedures to resolve claim issues.
• Acquires the ability to answer and direct questions on claims and procedures.
• Develops the ability to compose quality written correspondence.
• Reviews estimates of damage. Applies current recommended vehicle repair and replacement procedures.
• Adheres to Corporate Claim Standards, Company Bulletins, and Company Code of Ethics.
• Acquires the knowledge to answer basis physical damage questions.

Specialized Knowledge and Skills Requirements

• Demonstrated knowledge of processing simple to moderately complex claims
• Demonstrated ability to communicate with customers and internal/external business partners
• Successfully applied knowledge of each phase of the claim handling process.
• Demonstrated fundamental understanding of policies and endorsements related to property and casualty claims

Travel Requirements

• Must be willing to travel for Catastrophe duty if necessary.
• This position requires travel up to 10% of the time.

Additional Job Information:

Additional Qualifications:

• Claims Center software experience preferred

• Experience with PIP or Med Pay claims preferred

• Experience with subrogation and/or identifying subrogation potential preferred

• Offer to selected candidate will be made contingent on the results of applicable background checks

• Offer to selected candidate is contingent on signing a non-disclosure agreement for proprietary information, trade secrets, and inventions

• Our policy restricts consideration of applicants needing employment sponsorship (visa) to specialty occupations. Sponsorship will not be considered for this position

• The candidate(s) selected for this role will be employed by AFICS, Inc. (American Family Insurance Claims Services, Inc.), an affiliate of American Family Mutual Insurance Company, S.I.

This position is fully remote/work from home. On occasion you may be asked to travel to an office location for in person engagement activities such as team meetings, training and culture events.

Preferred locations for this role include:

Madison, WI; Chicago, IL; Boston, MA Minneapolis, MN; Denver, CO; Phoenix, AZ; Nashville, TN; Atlanta, GA; Seattle, WA; Las Vegas, NV; St. Joseph, MO; Kansas City, MO; St. Louis, MO; Green Bay, WI; Milwaukee, WI; Akron, OH; Keene, NH; Jacksonville, FL

#LI-REMOTE

When you work at American Family you can expect benefits that support your physical, emotional, and financial wellbeing. You will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health. We also offer a competitive 401(k) contribution, a pension plan, an annual incentive, and a paid-time off program. In addition, our student loan repayment program and paid-family leave are available to support our employees and their families. Interns and contingent workers are not eligible for American Family Enterprise benefits.

We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law.

Stay connected: Join Our Enterprise Talent Community!

#LI-CW1