Sr. Claim Specialist - Michigan PIP & Litigation

About the role

The Auto Club Group is seeking a Senior Claim Specialist to handle complex claims, particularly those involving MCCA or quadriplegic, traumatic brain, amputations, and other catastrophic injuries. This role requires a high level of authority and negotiation skills.

Responsibilities

• Review and contact insureds and other parties to set expectations and initiate documentation.
• Complete coverage analysis and ensure all policyholder benefits are identified.
• Create sub-claims and conduct thorough damage evaluations.
• Evaluate financial value of losses and approve payments.
• Refer claims to other units as necessary.
• Document claim files and close out claims using the claims management system.
• Utilize strong negotiating skills to resolve complex claim settlements.
• Handle MCCA and attorney-represented claims, working with insureds, physicians' offices, and medical insurance carriers.

Requirements

• Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge.
• Hold a valid driver's license if required for in-person inspections or meetings.
• Have five years of experience in complex claim settlements, negotiations, and evidence preparation.
• Be proficient in Essential Insurance Act (Michigan), Fair Trade Practices Act, subrogation procedures, and litigation.
• Have advanced technical knowledge of negligence law, no-fault law, medical terminology, and MCCA.
• Have strong communication and problem-solving skills.

Qualifications

• Associate degree in Business Administration, Insurance, or a related field, or equivalent 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 preferred.

Skills

• Negotiation of complex claim settlements.
• Securing and evaluating evidence.
• Preparing manual and electronic estimates.
• Subrogation claims.
• Taking statements.
• Establishing clear evaluation and resolution plans for claims.
• Advanced technical knowledge of negligence law, no-fault law, medical terminology, and MCCA.
• Handling claims to the line.
• Claim Handling Standards.
• Following and applying ACG Claim policies, procedures, and guidelines.
• Using basic PC software for claim file review and investigations.
• Demonstrating effective communication and customer service skills.
• Analyzing and solving problems with sound decision-making skills.
• Prioritizing claim-related functions.
• Managing time, organizing, and planning workload.
• Attending virtual meetings and corporate/court onsite meetings.

Benefits

Competitive annual salary between $76,700 to $102,000, along with a comprehensive benefits package including medical, dental, and vision benefits, 401(k) match, paid parental leave, adoption assistance, paid time off, company-paid holidays, CEO days, and floating holidays, tuition assistance, professional certification reimbursement, and AAA membership discounts.