Sr. Litigation Adjuster (Michigan PIP) - Meemic

The Auto Club Group; Ohio; On-site; USD 74,000 - 100,000; Full time

Job summary

An established industry player is seeking a Senior Claim Specialist to manage complex claims with minimal supervision. This role involves reviewing claims, conducting thorough investigations, and collaborating with various stakeholders, including physicians and insurance carriers. The ideal candidate will have advanced technical knowledge of relevant laws and procedures and a strong ability to negotiate effectively. With a focus on quality service and innovation, this opportunity offers a rewarding career path in a supportive and inclusive environment, where your contributions will make a significant impact.

Benefits

401k match

Medical insurance

Dental insurance

Vision insurance

Paid time off

Paid holidays

Tuition reimbursement

Qualifications

• Completion of ACG Claim Representative Training Program or equivalent experience.
• Five years in negotiation of complex claims and establishing claim resolution plans.

Responsibilities

• Review assigned claims and contact the insured and affected parties.
• Conduct thorough reviews of damages and determine applicability of state law.
• Document and code the claim file thoroughly and complete all claim closure activities.

Skills

Negotiation of complex claims

Evidence evaluation

Estimate preparation

Subrogation

Coverage resolution

Medical terminology

Communication

Relationship building

Problem analysis

Task prioritization

Education

Associate degree in Business Administration

Insurance certifications (CIC, CPCU)

Job description

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

JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD

Job Type:

Full time

Exempt/Non Exempt:

Salary

Job Description:

Sr. Litigation Adjuster (Michigan PIP) - MeemicWhat you will do:The Auto Club Group is seeking a prospective Senior Claim Specialist who can work under minimal 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.
• Investigate the facts regarding the claim to determine if the claim should be paid, considering applicable limits or exclusions and potential recovery.
• 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).
• Document and code the claim file thoroughly and complete all claim closure activities in the management system.
• Utilize strong negotiating skills.

Senior Claim Specialists assigned to the PIP unit are responsible for claims involving the MCCA or catastrophic injuries such as quadriplegic, traumatic brain injuries, amputations, etc. The role requires proficiency in dealing with MCCA and attorney-represented claims. Work involves collaboration with insureds, physicians' offices, and medical insurance carriers to gather necessary information for claim review and determinations.With our brand strength and mentoring, you will find your role as a Senior Claim Specialist can lead to a rewarding career at our growing organization.Work EnvironmentThis position can be performed remotely from a home office unless occasional travel for meetings, team activities, or training is required, subject to policy updates.Benefits:

• Annual salary of $74,900 to $99,800 with bonus potential based on performance.
• Comprehensive benefits including 401k match, medical, dental, vision, PTO, paid holidays, and tuition reimbursement.

Candidate Requirements:Minimum Qualifications:

• Completion of ACG Claim Representative Training Program or equivalent experience.
• In states requiring an Adjuster's license, eligibility to acquire and maintain the license within 90 days of hire.
• Valid State Driver's License.

Experience:

• Five years in negotiation of complex claims, evidence evaluation, estimate preparation, subrogation, coverage resolution, statement taking, and establishing claim resolution plans.

Knowledge and Skills:

• Advanced technical knowledge of relevant laws and procedures, including Michigan Insurance Act, Fair Trade Practices Act, subrogation, arbitration, and litigation.
• Proficiency in negligence law, no-fault law, medical terminology, and handling attorney-represented claims.

Additional Skills:

• Ability to handle claims according to standards, follow policies, work within claim systems, conduct investigations, communicate effectively, build relationships, analyze problems, prioritize tasks, and manage workload efficiently.

Preferred Qualifications:

• Associate degree in Business Administration, Insurance, or related field, or equivalent work experience.
• Insurance certifications such as CIC, CPCU, or completion of related programs.

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Who We Are

Become a part of something bigger.

The Auto Club Group (ACG) serves over 14 million members across multiple states and territories, offering insurance, travel, and financial services. As part of AAA, we are committed to quality service and innovation.

Joining our team means being part of an inclusive environment that values diversity and viewpoints. Learn more at www.aaa.com

Important Note:

Our compensation philosophy is to offer market-competitive, fair, and performance-based pay, with geographic adjustments. Salary offers depend on various factors, including location.

Our job functions and requirements are described above. Reasonable accommodations are available for qualified applicants.

We are an equal opportunity employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability, or veteran status.

Attendance is essential for this role. We conduct background and drug screens as part of our employment process.