Senior Claim Specialist

*** This position requires you to reside in the State of Michigan, preferably within the Metro-Detroit Area. In this position you are currently able to work remotely from your home; for day-to-day operations, with occasional "TRAVEL" for meetings (mediation, depositions & more), collaborative activities, or team building activities specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. ***

Senior Casualty Litigation Specialist (Michigan) – The Auto Club Group

Reports to: Claim Manager II

What you will do: (Primary Duties & Responsibilities)

The Auto Club Group is seeking a prospective Senior Claim Specialist to work under less supervision with a high-level of authority.

In this position, you will have the opportunity to:

• Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim process, and initiate 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 assigned Liability/BI/Med Pay/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.

How you will benefit:

Claim Specialist Will earn a competitive salary of $80,000 to $97,000 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:

• 401k Match

• Medical

• Dental

• Vision

• PTO

• Paid Holidays

• Tuition Reimbursement

We’re looking for candidates who: (Preferred/Required 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

• 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 in the following:

• Negotiation of complex 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:

• Advanced technical knowledge  

• Essential Insurance Act (Michigan)

• Fair Trade Practices Act as it relates to claims.

• Subrogation procedures and processes

• Intercompany arbitration

• Litigation

• Strong negotiation skills

• A good teamwork orientation

Advanced technical knowledge of:

• Negligence Law

• No-Fault Law

• Medical terminology and human anatomy

• Attorney represented claims.

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 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 critical thinking and decision-making skills

• Prioritize claim related functions

• Process time sensitive data and information from multiple sources

• Manage time, organize and plan workload and responsibilities

• Attend virtual meetings and corporate/court onsite meetings

• Work evenings or weekends

• Must Reside in the State of Michigan

Work Environment

This is a hybrid work arrangement (time spent in office and remote). Depending on the employee's role and leadership's assessment, some employees will come into an ACG facility on a weekly basis, a monthly basis, or on an "as needed" basis for key meetings and collaborative activities. Most employees will be required to come into the office, at a minimum, for important departmental meetings or teambuilding events.

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