Claims PIP Adjuster

Wolverine Insurance Company; Dowagiac (MI); Hybrid; USD 60,000 - 80,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401k

Job summary

A leading insurance firm in Michigan is looking for a Claims Adjuster to manage PIP and UM/UIM claims. This role requires strong communication and customer service skills, with a focus on claim investigation and process management. Candidates should have 3 to 5 years of relevant experience and knowledge of Michigan No-Fault Law. Full-time position available with possible hybrid schedule and comprehensive benefits.

Qualifications

• 3 to 5 years related experience.
• Knowledge of Michigan No-Fault Law and related legal practices.

Responsibilities

• Investigate and process PIP and UM/UIM claims.
• Deliver customer service to policyholders and agents.
• Set reserves based on claim evaluation.
• Monitor claim handling through self-audit processes.

Skills

Effective communication skills

Customer service skills

Problem analysis and decision making

Time management and organization

Job description

Overview

We are hiring a Claims Adjuster specializing in PIP, Med Pay, LTD, UM/UIM. Full-time with possible hybrid schedule. Benefits include Health, Dental, Vision, and 401k.

Responsibilities

• Under minimal supervision, follow standard procedures with independent judgement: Investigate, evaluate, process to conclusion Michigan PIP, Indiana Med Pay, and BI/UM/UIM claims
• Obtain information necessary for determination of coverage, order for priority, compensability, liability, and related injuries or damages
• Monitor appropriate claim handling through self-audit process
• Set reserves based on claim evaluation and investigation
• Deliver superior customer service to policyholders and agents
• Work with MCCA and attorney-represented claims
• Work with Review Works on assigned claims, contact insured and other involved parties, explain claim process, coverage/benefits available, and initiate documentation to parties

Strong Abilities

• Perform claim file review and investigations
• Demonstrate effective communication skills (verbal and written)
• Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and promptly responding to questions and concerns
• Communicate clearly with insureds, claimants, nurse case managers, medical providers and appraisers to keep all parties informed and address concerns
• Analyze and solve problems while demonstrating sound decision making skills
• Prioritize claim related functions
• Process time sensitive data and information from multiple sources
• Manage time, organize and plan workload and responsibilities
• Research, analyze, and interpret subrogation laws in various states

Qualifications

• 3 to 5 years related experience
• Knowledge/Skills: Michigan No-Fault Law, Negligence Law, Essential Insurance Act, Fair Trade Practices Act, subrogation procedures and processes, intercompany arbitration, handling non-complex litigation, basic medical terminology and human anatomy, MCCA and attorney-represented claims

Seniority level

• Mid-Senior level

Employment type

• Full-time

Job function

• Finance and Sales

Industries

• Insurance