Remote PIP Claims Specialist II

Blue Cross Blue Shield of Michigan; Michigan; Hybrid; USD 57,000 - 95,000; Full time

Job summary

Blue Cross Blue Shield of Michigan is seeking an intermediate level Claim Representative II to manage a caseload of Michigan No-Fault PIP claims of moderate to high complexity. The role requires knowledge of No-Fault law, coverage verification, injury causation, and litigation management.

This is a fully remote opportunity for Michigan residents. You will investigate, determine compensability, establish reserves, review medical bills, negotiate settlements, and collaborate with insureds,

Qualifications

• Bachelor’s degree or MACP experience may be considered.
• Three years’ MCAP claims experience preferred.
• Bilingual skills preferred.

Responsibilities

• Investigates and determines compensability under Michigan No-Fault.
• Establishes reserves based on claim profile and authority.
• Reviews medical bills related to No-Fault claims and approves payments.
• Negotiates settlements with attorneys or injured parties within authority.
• Coordinates with insureds, providers, attorneys and internal partners.
• Keeps abreast of Michigan No-Fault laws and related case law.

Skills

Claims handling

PIP knowledge

Negotiation

Communication

Decision making

Education

Bachelor’s degree

Tools

MS Office

Job description

Blue Cross Blue Shield of Michigan is seeking an intermediate level Claim Representative II to manage a caseload of Michigan No-Fault PIP claims of moderate to high complexity. The role requires knowledge of No-Fault law, coverage verification, injury causation, and litigation management.

This is a fully remote opportunity for Michigan residents. You will investigate, determine compensability, establish reserves, review medical bills, negotiate settlements, and collaborate with insureds,