Sr. Claim Specialist - Michigan PIP & Litigation

3M HEALTHCARE; Deutschland; Vor Ort; EUR 67.251 - 89.434; Vollzeit

Benefits dieser Stelle

Sign-on bonus

Medical insurance

Dental coverage

Vision coverage

401(k) match

Parental leave

PTO & holidays

Floating holidays

Volunteer day

Tuition assistance

Certification reimbursement

AAA discounts

Zusammenfassung

Auto Club Group in Michigan is seeking a Sr. Claim Specialist – PIP & Litigation to manage complex claims, negotiate settlements, and ensure accurate coverage determinations.

The role supports remote day-to-day operations with occasional travel for meetings and team activities, and requires successful in-person court presence when needed. The ideal candidate brings extensive negotiation experience, strong investigative and analytical skills, and a track record of coordinating with insureds,

Qualifikationen

• Five years of experience in negotiation of complex claim settlements, evidence evaluation, subrogation claims, and coverage questions.
• Ability to analyze coverage, determine payment amounts, and manage subrogation processes.
• Experience handling attorney-represented claims and coordinating with medical providers.

Aufgaben

• Review assigned claims, contact insured and parties, set expectations, and document in the claim system.
• Complete coverage analysis on complex claims and identify benefits.
• Create sub-claims if needed.
• Investigate thoroughly, evaluate limits, exclusions, and recovery potential, and determine payments.
• Perform detailed damage reviews and apply applicable laws to value losses.
• Approve payments and route claims to Underwriting, Recovery, or SI when needed.
• Document and code files and close in the system.
• Utilize strong negotiating skills.
• Handle catastrophic claims involving severe injuries and attorney-represented scenarios.

Kenntnisse

Negotiation

Claims handling

Investigations

Communication

Time management

Ausbildung

Associate degree in Business Administration or Insurance

ACG Claim Training Program

State Adjuster license eligibility within 90 days

Tools

Claims handling systems

Jobbeschreibung

Sr. Claim Specialist – Michigan PIP & Litigation

Full‑time, exempt position located in Michigan. A $5,000 sign‑on bonus is available for qualified candidates. Residency within the State of Michigan is required due to in‑person court appearances.

What you will do:

• Review assigned claims, contact the insured and affected parties, set expectations, and initiate documentation in the claim handling system.
• Complete coverage analysis on highly complex claims and identify all possible policyholder benefits.
• Create additional sub‑claims if needed.
• Conduct thorough investigations, evaluate limits, exclusions, and recovery potential, and determine payment amounts.
• Perform detailed damage reviews, apply state law and other related factors, and calculate the financial value of the loss.
• Approve payments for appropriate parties and refer claims to other units (Underwriting, Recovery, Claims Special Investigation) when necessary.
• Document and code claim files and complete all closure activities in the assigned system.
• Utilize strong negotiating skills.

Senior Claim Specialist – PIP Unit Responsibilities

• Handle claims involving MCCA or quadriplegic, traumatic brain injury, amputations, and other catastrophic injuries.
• Manage attorney‑represented claims and coordinate with insureds, physicians’ offices, and medical insurance carriers to obtain necessary information.

Work Environment

This position can be performed remotely from a home office for day‑to‑day operations, with occasional travel for meetings, collaborative activities, or team building as specified by leadership. This is subject to change based on amendments to the ACG Flex Work policy.

Benefits

• Competitive annual salary between $76,700 and $102,000.
• Medical, dental, and vision benefits.
• 401(k) match.
• Paid parental leave and adoption assistance.
• Paid Time Off (PTO), company holidays, CEO days, and floating holidays.
• Paid volunteer day annually.
• Tuition assistance program and professional certification reimbursement.
• AAA Membership discounts, perks, and rewards.

Required Qualifications

• Completion of the ACG Claim Representative Training Program or equivalent knowledge/experience.
• Eligibility to obtain a State Adjuster’s license within 90 days of hire, where required.
• Valid driver’s license if the role involves in‑person inspections or frequent meetings.
• Five years of experience in negotiation of complex claim settlements, evidence evaluation, manual and electronic estimates, subrogation claims, coverage question resolution, statement taking, and establishing resolution plans.
• Advanced technical knowledge of the Essential Insurance Act, Fair Trade Practices Act, subrogation procedures, intercompany arbitration, litigation, negligence law, no‑fault law, medical terminology, MCCA, and attorney‑represented claims.
• Ability to handle claims to the line, apply ACG Claim policies and procedures, work within assigned ACG Claim systems, perform file reviews and investigations, demonstrate effective communication and customer service, solve problems, prioritize functions, and manage time and workload.

Preferred Qualifications

• Associate degree in Business Administration, Insurance, or 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.

Who We Are

The Auto Club Group (ACG) offers membership, travel, insurance, and financial services to over 14 million members across 14 states and two U.S. territories under AAA, Meemic, and Fremont brands. ACG is the second‑largest AAA club in North America, dedicated to quality service and life‑enrichment through innovative technology and a skilled workforce.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. Regular and reliable attendance is essential. A background and drug screen will be required for all employees.