Intermediate Claim Specialist - Michigan PIP

About the role

The Auto Club Group is seeking a Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. 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.

Responsibilities

• Reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system.
• Completing complex coverage analysis.
• Ensuring all possible policyholder benefits are identified.
• Creating additional sub-claims if needed.
• Conducting thorough reviews of damages and determining the applicability of state law and other factors related to the claim.
• Evaluating the financial value of the loss.
• Approving 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 documenting and/or coding the claim file and completing all claim closure and related activities in the assigned claims management system.
• Utilizing strong negotiating skills.

Requirements

• 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.

Qualifications

• 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 and Skills: Advance 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.
• Ability: 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 workload and responsibilities, Research, analyze, and interpret subrogation laws in various states.

Skills

• Advance 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.

Benefits

ACG offers excellent and comprehensive benefits packages, including:

• Medical, dental and vision benefits
• 401k Match
• Paid parental leave and adoption assistance
• Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
• Paid volunteer day annually
• Tuition assistance program, professional certification reimbursement program and other professional development opportunities
• AAA Membership Discounts, perks, rewards, and much more

Pay

A competitive annual salary between $67,300 to $75,000

Schedule

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.