Medical Only Claims Trainee
No salary listed
Entry
Associate's
Lansing, MI, USA
In Person
InsuranceClaims Adjudication
About the job
Requirements
- A high school diploma and two years of insurance experience, which may include finance, medical, or other applicable experience, or an associate degree in insurance, business administration, health administration, or a related field.
- General knowledge of insurance operations.
- Ability to work effectively in a multifunctional business unit.
- Verbal and written communication skills.
- Ability to use diplomacy, discretion, and appropriate judgment when responding to inquiries from staff and external customers and anticipating departmental needs.
- Ability to exchange information clearly and concisely, present ideas and facts, and respond to questions appropriately.
- Ability to negotiate, build consensus, and resolve conflict.
- Organizational skills and ability to prioritize work.
- Ability to manage multiple priorities and meet established deadlines.
- Ability to perform mathematical calculations.
- Analytical and problem-solving skills.
- Ability to use reference manuals.
- Basic knowledge of medical terminology.
- Ability to comprehend issues, address them, or refer them for appropriate decision-making.
- Ability to work with minimal direction.
- Ability to proofread documents for spelling, grammar, punctuation, and format accuracy.
- For external candidates, successful completion of the 180-day probationary period requires obtaining an adjuster license in Michigan or Texas.
Responsibilities
- Assist Medical Only Claims Specialists with investigating and managing workers' compensation claims.
- Assist in determining and managing ongoing medical treatment, including directing care, creating provider panels, and approving provider requests.
- Evaluate medical reports and correspondence and take or document appropriate action.
- Support customer service work and processes for the multifunctional claims team, communicating and collaborating with team members to ensure appropriate and timely handling of claims in other states.
- May act as backup to a Medical Only Claims Specialist, including verifying workers' compensation coverage of employers and injured employees.
- Document claim details with potential for subrogation.
- Approve payments based on knowledge of the treatment plan and medical support showing the treatment's relationship to the injury.
- Resolve and close files after claims are resolved, meeting internal performance standards and complying with state legislation to avoid penalties and manage expenses.
- Coordinate with outside vendors on cost-containment efforts.
- Establish and maintain effective working relationships with internal and external customers, and assist in determining appropriate responses to regulatory inquiries.
- Compose correspondence and reports related to workers' compensation claims and set appropriate diaries.
- Read, route, and key incoming mail; run reports; respond to incoming calls on direct and automatic call distribution lines, faxes, and emails; and cover peers' work during absences to provide uninterrupted customer service.
- Develop skills toward the more complex responsibilities of the Medical Only Claims Specialist I position.
- Increase knowledge of the company's operations and workers' compensation insurance.
Desired Qualifications
- An associate degree is preferred.
- Progress toward or completion of Insurance Institute of America or another insurance-related designation is preferred.
About the company
AF Group is a holding company that spans several specialty insurance companies. It focuses on creating tailored insurance solutions by using its expertise in underwriting and medical management, and it reaches customers through a network of independent agents. The group’s products include property and casualty coverage as part of its expanding specialty portfolio. Rather than selling directly, AF Group grows by acquiring and integrating insurance businesses that complement its existing offerings, such as AmeriTrust Group, to strengthen its market position. The company emphasizes financial stability, holding an A rating from A.M. Best, which signals solid solvency and reliability. AF Group’s main goal is to broaden its specialty insurance offerings and improve outcomes for clients by combining diverse insurers under one umbrella and leveraging a broad distribution network.
Company Size
501-1,000
Company Stage
N/A
Total Funding
N/A
Headquarters
Lansing, Michigan
Founded
1912
Get referred to AF Group
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Simplify's Take
What believers are saying
- AF Group reported $3.3 billion gross written premium in 2025.
- Mike Valiante became Commercial Markets president in February 2026, sharpening specialty growth execution.
- Enstar said AF Group will operate largely standalone after closing, preserving its agency relationships.
What critics are saying
- Enstar's 2026 acquisition needs regulators; any delay freezes strategic decisions until year-end.
- Workers' compensation losses spike after severe claims inflation and adverse reserve development.
- Independent-agent distribution weakens if competitors poach brokers during ownership transition.
What makes AF Group unique
- AF Group writes specialty insurance across all 50 states through independent agents.
- Its workers' compensation expertise pairs underwriting discipline with medical management.
- Lisa Corless and long-tenured operators maintained continuity through AmeriTrust integration since 2023.
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Benefits
- Remote Work Options