Sr. Claim Specialist - PIP Litigation

AAA-The Auto Club Group•MI-Admin Office Building (AOB), MI

9d•$76,700 - $119,434•Hybrid

About The Position

Join AAA – The Auto Club Group as a Senior Michigan PIP Claim Specialist – Litigation, independently managing complex and litigated Michigan PIP claims. The role uses expertise in Michigan No-Fault/PIP claims, complex investigations, litigation management, and negotiation to evaluate exposures, develop claim strategies, resolve disputed matters, and move files toward timely, effective outcomes. The position can be performed remotely from a home office for day-to-day operations, but candidates must reside in Michigan. The specialist must be prepared to represent AAA – The Auto Club Group in court proceedings and travel throughout Michigan as needed for court appearances, litigation matters, and other business needs. Senior PIP specialists handle claims involving the MCCA and catastrophic injuries, including quadriplegia, traumatic brain injuries, and amputations. The role involves working with insureds, guardians, conservators, attorneys, treatment teams, and case managers to obtain information and make appropriate claim determinations. The schedule is Monday through Friday, 8:00 a.m. to 5:30 p.m. ET. This work arrangement is subject to change under ACG’s Flex Work policy. The position earns an annual salary of $76,700–$119,433.60 and offers an opportunity for an annual company bonus incentive.

Requirements

Complete the ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience.
Where a state adjuster’s license is required, be eligible to acquire it within 90 days of hire and maintain it as required.
Have a valid driver’s license if the role’s primary responsibilities involve in-person inspections or frequent in-person meetings with members.
Have five years of experience or equivalent training in negotiating claim settlements, securing and evaluating evidence, preparing manual and electronic estimates, handling subrogation claims, resolving coverage questions, taking statements, and establishing clear claim evaluation and resolution plans.
Advanced knowledge of the Michigan Essential Insurance Act, Fair Trade Practices Act as it relates to claims, subrogation procedures and processes, intercompany arbitration, and simple litigation.
Advanced knowledge of negligence law, No-Fault Law, No-Fault Reform, medical terminology and human anatomy, and MCCA and attorney-represented claims.
Handle claims according to Claim Handling Standards and apply ACG Claim policies, procedures, and guidelines.
Work within ACG Claim systems, including basic PC software, and perform basic claim file reviews and investigations.
Demonstrate effective verbal and written communication and customer service skills, building and maintaining relationships with insureds and claimants while responding to their questions and concerns.
Analyze and solve problems, demonstrate sound decision-making, prioritize claim-related functions, and process time-sensitive information from multiple sources.
Manage time, organize and plan workload and responsibilities.
Research, analyze, and interpret subrogation laws in various states.
Reside in Michigan and be prepared to represent AAA – The Auto Club Group in court and travel throughout the state as needed.
Be able to relocate, work evenings or weekends.

Nice To Haves

Associate degree in Business Administration, Insurance, or a related field, or equivalent related work experience.
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, contact insureds and other affected parties, set expectations about the claim process, and initiate documentation in the claims system.
Complete complex coverage analyses and identify all applicable policyholder benefits.
Create additional sub-claims when needed.
Investigate claim facts to determine whether a claim should be paid, applicable limits or exclusions, and possible recovery potential.
Review damages and determine the applicability of state law and other relevant factors.
Evaluate the financial value of losses and approve payments for appropriate parties.
Refer claims to other company units when necessary, including Underwriting, Recovery Units, or the Claims Special Investigation Unit.
Document and/or code claim files thoroughly and complete claim closure and related activities in the claims management system.
Negotiate claim resolutions using strong negotiation skills.
Handle PIP claims involving the MCCA and catastrophic injuries, including quadriplegia, traumatic brain injuries, and amputations.
Work with insureds, guardians, conservators, attorneys, treatment teams, and case managers to obtain information and complete claim reviews.
Represent AAA – The Auto Club Group in court proceedings and travel throughout Michigan as needed for court appearances, litigation matters, and other business needs.
Safely operate a motor vehicle to visit repair facilities, homes, patients, and other locations as needed.
Travel outside the assigned territory, which may involve overnight stays.

Benefits

Competitive annual salary of $76,700–$119,433.60 and opportunity for an annual company bonus incentive.
Medical plans with multiple coverage options, including HSA eligibility.
Prescription drug coverage.
Dental and vision benefits.
Employee Assistance Program with confidential support services.
Company-paid basic life insurance and optional supplemental life insurance and dependent coverage.
Short-term and long-term disability coverage.
Critical illness, accident, and pet insurance options.
401(k) plan with 50% company match on employee contributions up to 6% of pay, subject to the stated payment timing, and an additional company contribution of 4% of pay each pay day.
Health Savings Account and Flexible Spending Account options.
Accrual-based paid time off, eligible after 90 days of employment; full-time new employees receive up to 12 PTO days annually, with accrual based on start date and possible additional PTO based on role or state and local requirements.
For full-time employees, 10 company-paid holidays annually, one mental health day, two floating holidays, and one volunteer day; holidays vary by business schedules.
Paid leave programs, including parental, bereavement, jury duty, and military leave.
Tuition assistance up to $5,250 annually, with 80% covered by ACG.
100% reimbursement for eligible professional certification programs.
Career development and advancement opportunities.
Complimentary AAA membership with roadside assistance and travel discounts.
Adoption assistance program.