Claim Specialist – Michigan PIP

Key Responsibilities

• Review assigned claims and initiate claim handling activities.
• Contact insureds and other affected parties to gather information and set expectations for the claims process.

• Qualifications

  • Required Education (including Minimum Education And Any Licensing/certifications): 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: Three years of experience or equivalent training in the following: Negotiation of claim settlements, Securing and evaluating evidence, Preparing manual and electronic estimates, Subrogation claims, Resolving coverage questions, Taking statements, Establishing clear evaluation and resolution plans for claims.
  • Knowledge Of: Advanced knowledge of: Essential Insurance Act (Michigan), Fair Trade Practices Act as it relates to claims, Subrogation procedures and processes, Intercompany arbitration, Handling simple litigation, Negligence Law, No-Fault Law, medical terminology and human anatomy, MCCA and attorney represented claims.
  • Skills: 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 basic 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 work load and responsibilities, Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc., Research analyze and interpret subrogation laws in various states, Travel outside of assigned territory which may involve overnight stay, Work evenings or weekends.