Remote Michigan PIP Claim Specialist

A career at The Auto Club Group (ACG) can be satisfying, exciting and rewarding. By aligning your professional development with our business objectives, ACG can help you attain your career goals — and make a difference. Get started by choosing the career that’s right for you.

Dearborn, MI

The Auto Club Group

AAA was founded over 100 years ago for the purpose of lobbying for driver and passenger rights, fair laws and safer vehicles — all to better promote the love of the open road and the adventure of driving. Since then, AAA has grown to over 50 million members strong, while providing valuable membership services such as roadside assistance. Additionally, AAA has broadened its horizons to include all types of travel-related services, as well as offer a variety of insurance and financial products and services. Today’s AAA is a national federation comprised of more than 50 individual clubs throughout the United States and Canada. Whether you’re traveling around the world or to the corner grocery store, planning a honeymoon or weekend road trip, learning to drive or in need of a battery boost, the best way to begin your journey is with AAA. http://michigan.aaa.com/

keywords: about acg,compensation,document,review,license,ability to do,knowledge,education,experience

Full Time

Competitive Compensation and Benefits Package

Overview: <p class="p1"><strong>About ACG</strong><br /> The Auto Club Group (ACG) provides membership, travel, insurance, and financial services offerings to approximately 13 million members and customers across 14 states and 2 U.S. territories through the AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second-largest AAA club in North America.<br /> <br /> <strong>Compensation</strong><br /> The Auto Club Group offers competitive compensation and benefits packages including a base salary with performance-based incentives; medical/dental/vision insurance, pension, 401(k), generous time off, a complimentary AAA Membership, and much more!</p>
Responsibilities: <strong>Job Description</strong> <p style="font-weight: 300;"><strong><span style="font-weight: 300;">Remote Michigan PIP Claim Specialist&nbsp;</span></strong><span style="font-weight: 300;"><strong>&ndash; The Auto Club Group</strong></span></p> <p style="font-weight: 300;"><span style="font-weight: 300;"><strong>What you will do: (Primary Duties &amp; Responsibilities)</strong></span></p> <p style="font-weight: 300;"><span style="font-weight: 300;">AAA The Auto Club Group is seeking a prospective&nbsp;<strong>Claim Specialist</strong>&nbsp;who can work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.</span></p> <p style="font-weight: 300;"><span style="font-weight: 300;">In this position, you will have the opportunity to:</span></p> <ul style="font-weight: 300;"> <li style="font-weight: 300;"><span style="font-weight: 300;">Review assigned claims</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.&nbsp;&nbsp;</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Complete complex coverage analysis.</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Ensure all possible policyholder benefits are identified.&nbsp;</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Create additional sub-claims if needed.&nbsp;</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">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.&nbsp;</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Evaluate the financial value of the loss.</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Approve payments for the appropriate parties accordingly.&nbsp;</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).&nbsp;</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.&nbsp;&nbsp;</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Utilize strong negotiating skills.</span></li> </ul> <p style="font-weight: 300;"><span style="font-weight: 300;"><strong>Claim Specialists</strong>&nbsp;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&rsquo; offices and medical insurance carriers to obtain necessary information to complete the claims review process and make the appropriate determinations</span></p> <p style="font-weight: 300;"><span style="font-weight: 300;"><strong>How you will benefit:</strong></span></p> <p style="font-weight: 300;"><span style="font-weight: 300;">Claim Specialists earn a competitive salary with annual bonus potential based on performance.&nbsp;</span><span style="font-weight: 300;">Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include:</span></p> <ul style="font-weight: 300;"> <li style="font-weight: 300;"><span style="font-weight: 300;">401k Match</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Medical</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Dental</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Vision</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">PTO</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Paid Holidays</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Tuition Reimbursement</span></li> </ul>
Requirements: <p style="font-weight: 300;"><strong>Qualifications</strong></p> <p style="font-weight: 300;"><span style="font-weight: 300;"><strong>We&rsquo;re looking for candidates who: (Preferred/Required Qualifications)</strong></span></p> <p style="font-weight: 300;"><span style="font-weight: 300;"><u style="font-weight: 300;">Education</u>:</span></p> <ul style="font-weight: 300;"> <li style="font-weight: 300;"><span style="font-weight: 300;">Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Completion of the Insurance Institute of America&rsquo;s: General Insurance Program, Associate in Claims, Associate in Management or equivalent</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">CPCU coursework or designation</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">In states where an Adjuster&rsquo;s license is required, the candidate must be eligible to acquire a State Adjuster&rsquo;s license within 90 days of hire and maintain as specified for appropriate states.</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Must have a valid State Driver&rsquo;s License</span></li> </ul> <p style="font-weight: 300;"><span style="font-weight: 300;"><u style="font-weight: 300;">Experience</u>:</span></p> <p style="font-weight: 300;"><span style="font-weight: 300;">Three years of experience or equivalent training in the following:</span></p> <ul style="font-weight: 300;"> <li style="font-weight: 300;"><span style="font-weight: 300;">Michigan PIP</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Negotiation of claim settlements</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Securing and evaluating evidence</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Preparing manual and electronic estimates</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Subrogation claims</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Resolving coverage questions</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Taking statements</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Establishing clear evaluation and resolution plans for claims</span></li> </ul> <p style="font-weight: 300;"><span style="font-weight: 300;"><u style="font-weight: 300;">Knowledge and Skills</u>:</span></p> <ul style="font-weight: 300;"> <li style="font-weight: 300;"><span style="font-weight: 300;">Advanced knowledge of:</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Essential Insurance Act (Michigan)</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Fair Trade Practices Act as it relates to claims</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Subrogation procedures and processes</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Intercompany arbitration</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Handling simple litigation</span></li> </ul> <p style="font-weight: 300;"><span style="font-weight: 300;"><u style="font-weight: 300;">Advanced knowledge of</u>:</span></p> <ul style="font-weight: 300;"> <li style="font-weight: 300;"><span style="font-weight: 300;">Negligence Law</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">No-Fault Law</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Medical terminology and human anatomy</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">MCCA and attorney represented claims</span></li> </ul> <p style="font-weight: 300;"><span style="font-weight: 300;"><u style="font-weight: 300;">Ability to</u>:&nbsp;</span></p> <ul style="font-weight: 300;"> <li style="font-weight: 300;"><span style="font-weight: 300;">Handle claims to the line Claim Handling Standards</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Follow and apply ACG Claim policies, procedures and guidelines</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Work within assigned ACG Claim systems including basic PC software</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Perform basic claim file review and investigations</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Demonstrate effective communication skills (verbal and written)</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Analyze and solve problems while demonstrating sound decision making skills</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Prioritize claim related functions</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Process time sensitive data and information from multiple sources</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Manage time, organize and plan work load and responsibilities</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Research analyze and interpret subrogation laws in various states</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Work evenings or weekends</span></li> </ul> <p style="font-weight: 300;"><span style="font-weight: 300;"><strong>What it&rsquo;s like to work for us:</strong></span></p> <p style="font-weight: 300;"><span style="font-weight: 300;">We serve our members by making their satisfaction our highest priority. We do what&rsquo;s right by sustaining an open, honest and ethical work environment. We lead in everything we do by offering best-in-class products, benefits and services. And we value our employees by seeking the best talent, rewarding high performance and holding ourselves accountable.</span></p> <p style="font-weight: 300;"><span style="font-weight: 300;">All in all, we create an inclusive and welcoming environment of diverse backgrounds, experiences and viewpoints, realizing our differences make us stronger.</span></p> <p style="font-weight: 300;"><span style="font-weight: 300;"><strong>Who we are:</strong></span></p> <p style="font-weight: 300;"><span style="font-weight: 300;">The Auto Club Group helps AAA Members enjoy life&rsquo;s journey with peace of mind by providing innovative solutions, advocacy and membership benefits wherever and whenever they need them. We currently conduct business in 13 states in the upper Midwest and the Southeast.</span></p> <p style="font-weight: 300;"><span style="font-weight: 300;">The Auto Club Group has established four long-term enterprise goals:</span></p> <ul style="font-weight: 300;"> <li style="font-weight: 300;"><span style="font-weight: 300;">Long-term, sustainable, profitable growth</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">AAA Membership growth and renewal</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Operational excellence</span></li> <li style="font-weight: 300;"><span style="font-weight: 300;">Become the &ldquo;flagship club&rdquo; of the AAA Federation</span></li> </ul> <p style="font-weight: 300;"><span style="font-weight: 300;">Important Note:</span></p> <p style="font-weight: 300;"><span style="font-weight: 300;">The above statements describe the principle 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 fulfil these requirements.</span></p> <p style="font-weight: 300;"><span style="font-weight: 300;">The Auto Club Group, and all of its affiliated companies, is an equal opportunity/affirmative action employer. &nbsp;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.</span></p> <p style="font-weight: 300;">#LI-LC1</p>