Sr. Claim Specialist (Michigan Liability) – Fremont

Posted 9 Days Ago
Be an Early Applicant
Hiring Remotely in MI, USA
Remote
77K-102K Annually
Senior level
Insurance
The Role
Handle highly complex Michigan liability claims including coverage analysis, investigations, valuation, negotiation, approving payments, subrogation, and referral to specialty units. Document and close claim files, apply state laws and company policies, and manage litigation/arbitration matters while mentoring and working with limited supervision.
Summary Generated by Built In

It’s a great time to join AAA The Auto Club Group! 

JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD

Job Type:

Full time

 

Exempt/Non Exempt:

 

Salary

Job Description:


 

Sr. Claim Specialist (Michigan Liability) – FremontReports to: Claim Manager as appropriate

What you will do:

The Auto Club Group is seeking prospective Senior Claim Specialist who can work under less supervision with a high-level of authority to handle highly complex technical issues and the most complex claims.In this position, you will have the opportunity to:
  • 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 coverage analysis on the most complex claims
  • 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.
Senior Claim Specialists are assigned Liability/BI/MedPay/Non-MI PIP claims involving litigation/arbitration.  Handle the most complex claims involving liability disputes, bodily injuries, and coverage questions. With our powerful brand and the mentoring, we offer, you will find your position as a Senior Claim Specialist can lead to a rewarding career at our growing organization.Work EnvironmentThis 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.How you will benefit:
  • A competitive annual salary between $76,772 to $102,000
  • 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
We’re looking for candidates who:Required Qualifications (these are the minimum requirements to qualify)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.
Experience:Five years of experience or equivalent training in the following:
  • Negotiation of complex Michigan claim settlements
  • Securing and evaluating evidence
  • Preparing manual and electronic estimates
  • Subrogation claims
  • Resolving complex 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
  • Litigation
Advance technical knowledge of:
  • Negligence Law
  • No-Fault Law
  • Medical terminology and human anatomy
Ability to:
  • 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
Preferred Qualifications:Education:
  • 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
  • CPCU coursework or designation
  • Commercial Claims

#LI-LC1

Who We Are

Become a part of something bigger.

The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.

By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life’s journey through insurance, travel, financial services, and roadside assistance.

And when you join our team, one of the first things you’ll notice is that same, whole-hearted, enthusiastic advocacy for each other.

We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.

To learn more about AAA The Auto Club Group visit www.aaa.com

Important Note:

ACG’s Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.  

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 its affiliated companies, is an equal opportunity 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.

Regular and reliable attendance is essential for the function of this job.

AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.

Skills Required

  • Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
  • Eligible to acquire State Adjuster's license within 90 days where required and maintain as specified
  • Valid driver's license if role requires in-person inspections or frequent meetings
  • Five years of experience (or equivalent training) negotiating complex Michigan claim settlements
  • Experience securing and evaluating evidence and taking statements
  • Experience preparing manual and electronic estimates
  • Experience handling subrogation claims and researching subrogation laws
  • Experience resolving complex coverage questions and establishing evaluation/resolution plans
  • Advanced knowledge of the Michigan Essential Insurance Act and No-Fault Law
  • Advanced knowledge of negligence law, medical terminology, and human anatomy
  • Knowledge of Fair Trade Practices Act as it relates to claims, intercompany arbitration, and litigation
  • Ability to perform claim investigations, evaluate damages, determine legal applicability, and approve appropriate payments
  • Proficiency with assigned claims management systems and basic PC software
  • Strong negotiation, communication (verbal and written), customer service, time management, and decision-making skills
  • Ability to follow ACG claim policies, coding, file documentation, and closure procedures
  • Associate degree in Business Administration, Insurance or related field (or equivalent experience)
  • Completion of Insurance Institute programs (General Insurance Program, Associate in Claims, Associate in Management) or equivalent
  • CPCU coursework or designation
  • Experience with Commercial Claims
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The Company
HQ: Dearborn, MI
26 Employees

What We Do

Auto Club Group Insurance Co is an insurance company based out of 1501 Washington Blvd, Detroit, Michigan, United States

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