Casualty Claim Specialist – Michigan PIP

AAA-The Auto Club Group

115d • $65,700 - $75,000

About The Position

The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to handle claim responsibilities including reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. You will complete complex coverage analysis, ensure all possible policyholder benefits are identified, create additional sub-claims if needed, and conduct thorough reviews of damages to determine the applicability of state law and other factors related to the claim. You will evaluate the financial value of the loss, approve payments for the appropriate parties, and refer claims to other company units when necessary. Claim Specialists are assigned to the PIP unit and are responsible for Michigan PIP intermediate claims involving fractures, mild closed head injuries, surgical procedures, and claims involving attendant care. The role may require proficiency in dealing with the MCCA and attorney represented claims. You will work with insureds, physicians’ offices, and medical insurance carriers to obtain necessary information to complete the claims review process and make appropriate determinations.

Requirements

• Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience.
• Eligible to acquire a State Adjuster’s license within 90 days of hire if required.
• A valid driver's license is required for conducting in-person inspections or meetings.
• Three years of experience or equivalent training in negotiation of claim settlements, securing and evaluating evidence, preparing estimates, subrogation claims, resolving coverage questions, and taking statements.

Nice To Haves

• Associate degree in Business Administration, Insurance or a related field.
• Completion of the Insurance Institute of America's General Insurance Program, Associate in Claims, Associate in Management or equivalent CPCU coursework or designation.

Responsibilities

• Review assigned claims and contact the insured and other affected parties.
• Set expectations for the remainder of the claim process.
• Initiate documentation in the claim handling system.
• Complete complex coverage analysis.
• Ensure all possible policyholder benefits are identified.
• Create additional sub-claims if needed.
• Conduct thorough reviews of damages and determine the applicability of state law.
• Evaluate the financial value of the loss.
• Approve payments for the appropriate parties.
• Refer claims to other company units when necessary.
• Document and/or code the claim file and complete all claim closure activities.
• Utilize strong negotiating skills.

Benefits

• 401k Match
• Medical
• Dental
• Vision
• PTO
• Paid Holidays
• Tuition Reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Bachelor's degree
• Number of Employees: 101-250 employees