Claim Representative II - Michigan

ViziRecruiter,LLC.; Michigan; On-site; USD 57,000 - 95,000; Full time

Job summary

AF Group in Lansing, Michigan seeks an experienced Claim Representative II to handle intermediate-level property and casualty claims. You will verify coverages, determine liability, and establish reserves within authority while navigating Michigan statutes.

The role requires a bachelor’s degree, three years of experience, and the ability to work remotely with occasional on-site visits to insured municipalities in Michigan.

Qualifications

• Bachelor’s degree or equivalent experience.
• Three years’ experience in property & casualty claims.
• Knowledge of Michigan municipal liability statutes/case law.

Responsibilities

• Verifies coverage of claimed property and casualty damage.
• Determines liability for claims by investigation and exclusions.
• Establishes reserves based on claim profile and authority.
• Negotiates settlements with attorneys or insureds within authority.
• Manages outside vendors and cost containment efforts.
• Maintains relationships with internal/external customers.

Skills

Computer skills

Medical terminology

Michigan liability

Property loss adjust

Negotiation

Prioritization

Education

Bachelor’s degree

Job description

Introduction

AF Group (Lansing, Mich.) and its subsidiaries are a premier provider of innovative insurance solutions. Insurance policies may be issued by any of the following companies within AF Group: Accident Fund Insurance Company of America, Accident Fund National Insurance Company, Accident Fund General Insurance Company, United Wisconsin Insurance Company, Third Coast Insurance Company, or CompWest Insurance Company.

Overview

This is the intermediate level of the claim handler career path. Handles moderate to difficult claims. Exercises progressively more discretion in the determination of compensability of claims.Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority. Works remotely with occasional travel to on-site visits with insured municipalities. Is a resident in the State of Michigan.

WORKING CONDITIONS:

Work is performed in an office setting or remote with no unusual hazards. Minimal travel required.

PAY RANGE:

Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $56,700 - $94,900.

Responsibilities

• Verifies coverage of claimed property and casualty damage.


• Determines liability for covered claims by thorough investigation of the claim and applicable exclusions.


• Analyzes liability for claims pursuant to Michigan municipal liability statutes and caselaw.


• Establishes timely and appropriate reserves based on the profile of the claim within given authority based on anticipated financial exposure.


• Documents specifics of claims with potential for subrogation recovery, including amount of potential recovery monies.


• Manages estimates and invoices for property, casualty and automobile claims, and approves payments based on support showing relationship to the cause of loss and legal liability for payment.


• Concludes and closes files following resolution of claims to meet internal performance standards while complying with state legislation to avoid penalties and manage expenses.


• Negotiates settlements with attorneys or injured parties within given authority at the earliest possible point to bring cases to final disposition.


• Works closely with manager on complex files or files above settlement/reserve authority.


• Manages outside vendors to ensure cost containment efforts.


• Establishes and maintainseffective workingrelationships with all internal and externalcustomers.


• Stays abreast of changes in municipal liability statutes and case law in order to accurately interpret and apply relevant laws.

ADDITIONAL RESPONSIBILITIES/TASKS:

• Administers complex claims and catastrophic exposures within authority, including claims from dedicated large accounts.


• Exercises independent judgment to settle cases prior to mediation or litigation.


• Actively participates in agent/client relationship management.


• Assists in mentoring team members.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

Requirements

EDUCATION OR EQUIVALENT EXPERIENCE:

• Bachelor’s degree in a related field.


• Relevant combination of education and experience may be considered in lieu of degree.


• Continuous learning, as defined by the Company’s learning philosophy, is required.


• Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE:

Claim Representative II:

• Three years' experience in property and casualty claims environment which provides the necessary skills, knowledge and abilities, such as experience in reviewing policy coverages and exclusions, drafting coverage letters, investigating and settling property and casualty losses, and adjusting claims through litigation and trial.


• Experience handling claims in multiple jurisdictions preferred.


• Bilingual skills preferred.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

• Ability and proficiency in the use of computers and company standard software specific to position.


• Knowledge of medical and legal terminology related to the work.


• Knowledge of Michigan municipal liability.


• Knowledge of best practices for adjusting property losses.


• Effective oral and written communication skills.


• Effective customer service skills.


• Ability to negotiate, build consensus and resolve conflict.


• Ability to manage multiple priorities and meet established deadlines.


• Attention to detail and analytical skills.


• Ability to work independently as well as within a team.

ADDITIONAL SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

Claim Representative II, III:

• Ability to make independent decisions.


• Ability to solve complex problems.