PIP Claims Specialist II

Blue Cross Blue Shield of Michigan; Lansing (MI); On-site; USD 57,000 - 95,000; Full time

Job summary

AF Group in Lansing, MI, is seeking an experienced Claim Representative II to manage a caseload of Michigan No-Fault PIP claims of moderate to high complexity. You will investigate coverage analysis, exposure, and claimant interaction, ensuring timely, accurate, and compliant processing, with regular collaboration with insureds, providers, and attorneys.

The role requires knowledge of Michigan No-Fault law, order of priority investigations, and litigation management.

Qualifications

• Bachelor’s degree or equivalent in a related field; MACP claim handling experience preferred.
• Certification or progress toward certification is highly preferred.
• Strong customer-service orientation with bilingual abilities.
• Ability to negotiate and resolve conflicts across complex claims.
• Experience handling Michigan No-Fault/PIP claims is advantageous.

Responsibilities

• Determines compensability under Michigan No-Fault and related plans via thorough investigation.
• Collaborates with manager on complex files and agent/client relationships to manage claims.
• Manages medical bills and reserves within authority; supports cost containment.
• Negotiates settlements with attorneys or injured parties within given authority.
• Maintains relationships with internal and external stakeholders and stays updated on No-Fault statutes.

Skills

Bilingual

Customer service

Negotiation

Conflict resolution

Complex problem solving

Education

Bachelor’s degree in a related field

MACP certification or progress toward

Job description

AF Group in Lansing, MI, is seeking an experienced Claim Representative II to manage a caseload of Michigan No-Fault PIP claims of moderate to high complexity. You will investigate coverage analysis, exposure, and claimant interaction, ensuring timely, accurate, and compliant processing, with regular collaboration with insureds, providers, and attorneys.

The role requires knowledge of Michigan No-Fault law, order of priority investigations, and litigation management.