Senior Litigation Casualty Claim Specialist - Michigan PIP

The Auto Club Group; Michigan; Remote; USD 74,000 - 100,000; Full time

Job summary

A major insurance company in Michigan is seeking a Senior Litigation Casualty Claim Specialist. This role involves managing complex claims with significant authority and responsibility. The successful candidate will benefit from a competitive salary ranging from $74,900 to $99,800 annually, along with a comprehensive benefits package. The position allows for remote work with occasional travel requirements.

Benefits

401k Match

Medical

Dental

Vision

PTO

Paid Holidays

Tuition Reimbursement

Qualifications

• Negotiation of complex claim settlements is essential.
• Valid driver's license is required if in-person meetings are frequent.
• Ability to analyze and solve complex claim issues.

Responsibilities

• Review complex claims and set expectations with involved parties.
• Conduct thorough investigations and document claims effectively.
• Approve payments and refer claims to necessary departments.

Skills

Negotiation of complex claim settlements

Securing and evaluating evidence

Subrogation claims

Effective communication skills

Education

Completion of ACG Claim Representative Training Program

Associate degree in Business Administration or related field

Job description

It's a great time to join AAA The Auto Club Group!

JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD

Job Description:

Senior Litigation Casualty Claim Specialist (Michigan PIP) - The Auto Club Group

The Auto Club Group is seeking a prospective Senior Claim Specialist who can work under less supervision with a high-level of authority to handle highly complex technical issues and the most complex claims.

In this position, you will have the opportunity to:

• Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.
• Complete coverage analysis on the most complex claims.
• Ensure all possible policyholder benefits are identified.
• Create additional sub-claims if needed.
• Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential.
• Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
• Evaluate the financial value of the loss.
• Approve payments for the appropriate parties accordingly.
• Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
• Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
• Utilize strong negotiating skills.

Senior Claim Specialist assigned to the PIP unit are responsible for claims involving the MCCA or quadriplegic, traumatic brain, amputations, and other catastrophic injuries. The role will require proficiency in dealing with the MCCA and attorney represented claims. Work with insureds, physicians' offices, and medical insurance carriers to obtain necessary information to complete the claims review process and make the appropriate determinations.

Work Environment

This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.

How you will benefit:

Senior Claim Specialist will earn a competitive salary of $74,900 to $99,800 annually with annual bonus potential based on performance.

Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include:

• 401k Match
• Medical
• Dental
• Vision
• PTO
• Paid Holidays
• Tuition Reimbursement

Required Qualifications

Education:

• Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
• In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states.
• A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.

Experience:

• Negotiation of complex claim settlements
• Securing and evaluating evidence
• Preparing manual and electronic estimates
• Subrogation claims
• Resolving complex coverage questions
• Taking statements
• Establishing clear evaluation and resolution plans for claims

Knowledge and Skills:

• Advanced technical knowledge of Essential Insurance Act (Michigan)
• Fair Trade Practices Act as it relates to claims
• Subrogation procedures and processes
• Intercompany arbitration
• Litigation

Advanced technical knowledge of:

• Negligence Law
• No-Fault Law
• Medical terminology and human anatomy
• MCCA and attorney represented claims

Ability to:

• Handle claims to the line Claim Handling Standards
• Follow and apply ACG Claim policies, procedures and guidelines
• Work within assigned ACG Claim systems including basic PC software
• 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 responding to questions and 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
• Attend virtual meetings and corporate/court onsite meetings

Preferred Qualifications

Education:

• Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
• Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent
• CPCU coursework or designation

The Auto Club Group, and all its affiliated companies, is an equal opportunity/affirmative action employer. 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.