Senior Claim Specialist - MI Casualty PIP Litigation
The Auto Club Group (ACG) provides membership, travel, insurance and financial services offerings to approximately 9 million members and customers across 11 states and 2 U.S. territories through the AAA, Meemic and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
Primary Duties and Responsibilities (details of the basic job functions):
Work under less supervision with a high-level of authority to handle highly complex technical issues and the most complex claims.
Independent handling of first party Michigan PIP litigated files with outside retained counsel and legal department for the Michigan market. Performs detailed and highly complex lawsuit reviews and evaluations for last ditch attempts and best outcomes. Provides guidance and technical support to staff members regarding specialized discipline. Assists manager in activities such as internal control reviews, special projects, external fraud investigations, and other related areas specific to the casualty litigation management unit.
- 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
- Auto No Fault PIP Claims
- Negotiation of complex claim settlements
- Securing and evaluating evidence
Knowledge and Skills:
Works in a temperature controlled office environment. Depending on line travel may be required to visit courts, attorney offices, patients, hospitals, rehabilitation centers, repair facilities, damaged homes, contractors, etc. per with exposure to road hazards and temperature extremes.
Required Qualifications (these are the minimum requirements to qualify)
Education (include 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.
- Must have a valid State Driver's License
- 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
Advanced technical knowledge of:
- Negligence Law
- No-Fault Law
- Medical terminology and human anatomy
- MCCA and attorney represented claims
- 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)
- 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 attend meetings off site
- Travel outside of assigned territory which may involve overnight stay
- Relocate, work evenings or weekends
- Participate in mediation, facilitation or arbitration hearings, trials and other court appointments
The Auto Club Group offers a competitive compensation and benefits package including a base salary with performance based incentives; medical/dental/vision insurance, pension, 401(k), generous time off, a complimentary AAA Membership and much more!
Important Note: The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.
The Auto Club Group, and all of 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.
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