Job Information
The Auto Club Group Claim Specialist PIP in Dearborn, Michigan
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Job Type: Full time
Exempt/Non Exempt: Salary
Job Description:
I. Position Description Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units. Resolve coverage questions, take statements and establish clear evaluation and resolution plans for claims. Will earn a competitive salary of $62,281 $76,000 annually with annual bonus potential based on performance.
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.
Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.
Claim handling responsibilities will include the following: 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. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed. Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. 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). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills.
Claim Specialist assigned to the Liability, Bodily Injury, Med Pay, MRTS and Non-MI PIP claim units will handle highly complex claims involving liability disputes, bodily injuries, and valued up to $300,000. Answer coverage and policy questions. Handle Med Pay claims in all states, and PIP claims in KY, MN and ND. Apply the correct liability determination, evaluate the damages and arrive at a fair settlement. May assist Claim Manager with file reviews and training.
II. 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
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: 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
Ability to:
handle claims to the line Claim Handling Standards follow a