Pip Claim Specialist Jobs

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Job Type:
Full time
Exempt/Non Exempt:
Salary
:
PIP Claims Specialist – The Auto Club Group
What you will do: (Primary Duties & Responsibilities)
AAA The Auto Club Group is seeking a prospective Claim Specialist who can work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.
In this position, you will have the opportunity to:

• Utilize strong negotiating skills.
• Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
• Review assigned claims,
• Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.
• Ensure all possible policyholder benefits are identified.
• Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
• Approve payments for the appropriate parties accordingly.
• Conduct thorough reviews of injuries and determine the applicability of state law and other factors related to the claim.
• Create additional sub-claims if needed.
• Complete complex coverage analysis.
• 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.

Claim Specialists assigned to the PIP unit are responsible for Michigan PIP intermediate claims involving fractures, mild closed head injuries, surgical procedures, and claims involving attendant care. The role will require proficiency in dealing with the MCCA and attorney represented claims. May handle losses beyond those identified previously. Work with insureds, physicians’ offices and medical insurance carriers to obtain necessary information to complete the claims review process and make the appropriate determinations.
Work Environment
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.
How you will benefit:
Claim Specialist will earn a competitive salary of $65,000 to $75,000 annually with annual bonus potential based on performance.
Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include:

• PTO
• 401k Match
• Vision
• Paid Holidays
• Medical
• Tuition Reimbursement
• Dental

We’re looking for candidates who: (Preferred/Required Qualifications)
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.
• Must have a valid State Driver's License
• CPCU coursework or designation
• Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent
• Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience

Experience:
Three years of experience or equivalent training in the following:

• Subrogation claims
• Preparing manual and electronic estimates
• Resolving coverage questions
• Establishing clear evaluation and resolution plans for claims
• Michigan PIP
• Taking statements
• Securing and evaluating evidence
• Negotiation of claim settlements

Knowledge and Skills:

• Handling simple litigation
• Fair Trade Practices Act as it relates to claims
• Subrogation procedures and processes
• Advanced knowledge of:
• Intercompany arbitration
• Essential Insurance Act (Michigan)

Advanced knowledge of:

• MCCA and attorney represented claims
• No-Fault Law
• Negligence Law
• Medical terminology and human anatomy

Ability to:

• Perform basic claim file review and investigations
• Follow and apply ACG Claim policies, procedures and guidelines
• 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.
• Manage time, organize and plan work load and responsibilities
• Process time sensitive data and information from multiple sources
• Analyze and solve problems while demonstrating sound decision making skills
• Prioritize claim related functions
• Handle claims to the line Claim Handling Standards
• Research analyze and interpret subrogation laws in various states
• Work within assigned ACG Claim systems including basic PC software

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