Talent.com
Casualty Specialist Michigan PIP

Casualty Specialist Michigan PIP

The Auto Club GroupReno, NV, US
6 days ago
Job type
  • Full-time
Job description

Casualty Specialist Michigan PIP The Auto Club Group

The Auto Club Group is seeking prospective Claim Specialist who will 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 :

  • 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 complex coverage analysis.
  • 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.

Claim Specialists are assigned to the PIP unit and are responsible for Michigan PIP intermediate claims involving fractures, mild closed head injuries, surgical procedures, and claims involving attendant care. The role may 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.

With our powerful brand and the mentoring, we offer, you will find your position as a Claim Specialist can lead to a rewarding career at our growing organization.

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.

Claim Specialist will earn a competitive salary of $65,700 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 :

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

  • Three years of experience or equivalent training in the following :
  • Negotiation of claim settlements
  • Securing and evaluating evidence
  • Preparing manual and electronic estimates
  • Subrogation claims
  • Resolving 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
  • Handling simple litigation
  • Advance knowledge of :
  • Negligence Law
  • No-Fault Law
  • Medical terminology and human anatomy
  • MCCA and 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 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
  • The Auto Club Group 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.

    Create a job alert for this search

    Specialist • Reno, NV, US

    Related jobs
    • Promoted
    CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST (CDIS), On-site Only, • •RELOCATION OFFERED • •

    CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST (CDIS), On-site Only, • •RELOCATION OFFERED • •

    Northern Nevada Health SystemSparks, NV, US
    Full-time +1
    When it comes to choosing a hospital, one thing is clear : quality and convenience count.Northern Nevada Medical Center's. Northern Nevada Medical Center is a 124-bed acute care hospital located on 2...Show moreLast updated: 30+ days ago
    • Promoted
    Clinical Supervisor (BCBA) - Fernely

    Clinical Supervisor (BCBA) - Fernely

    GOALS for Autism, Inc.Fernley, NV, US
    Full-time
    Board Certified Behavior Analysts.GOALS for Autism is a values driven company dedicated to the needs of clients and their families emphasizing a community and team based approach.GOALS is an establ...Show moreLast updated: 30+ days ago
    • Promoted
    Border Patrol Agent - Experienced (GL9 / GS11)

    Border Patrol Agent - Experienced (GL9 / GS11)

    U.S. Customs and Border ProtectionHerlong, California, US
    Full-time +1
    Check out these higher-salaried federal law enforcement opportunities with the U.Your current or prior law enforcement experience may qualify you for this career opportunity with the nation's premi...Show moreLast updated: 30+ days ago
    • Promoted
    Interventional Radiology Tech

    Interventional Radiology Tech

    Phoenix Children'sFernley, NV, United States of America
    Full-time
    This position performs radiographic procedures for interventional studies in specialized areas.This position receives supervision of work activities from the Mgr, Diagnostic Imaging and this positi...Show moreLast updated: 30+ days ago
    • Promoted
    United States Border Patrol Agent

    United States Border Patrol Agent

    U.S. Customs and Border ProtectionFernley, NV, US
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 10 days ago
    • Promoted
    LS - Safety / Training Manager

    LS - Safety / Training Manager

    Atlantic AviationReno, NV, US
    Full-time
    The Safety and Training Manager trains and evaluates new hire employees on company policies and procedures as well as industry practices with respect to operations. This position conducts annual rec...Show moreLast updated: 12 days ago
    • Promoted
    United States Customs and Border Protection Officer

    United States Customs and Border Protection Officer

    U.S. Customs and Border ProtectionDoyle, California, US
    Full-time +1
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 27 days ago
    • Promoted
    Safety Professional

    Safety Professional

    Harder Mechanical ContractorsSparks, NV, US
    Full-time
    Harder Mechanical is one of the nation’s largest mechanical contractors with an outstanding reputation for working safely, meeting tough schedules, and delivering quality projects.Based in Po...Show moreLast updated: 12 days ago
    • Promoted
    Mental Health Therapist

    Mental Health Therapist

    SonderMind CareersSilver Springs, NV, US
    Full-time
    SonderMind is a leading mental health care platform revolutionizing therapy services by empowering licensed mental health therapists to deliver exceptional care with cutting-edge, AI-powered tools....Show moreLast updated: 30+ days ago
    • Promoted
    Physical Therapist - $10,000 Sign On Bonus + Relocation Available

    Physical Therapist - $10,000 Sign On Bonus + Relocation Available

    Phoenix Children'sCold Springs, NV, United States of America
    Full-time
    This position provides physical therapy services to pediatric population, neonate to adolescence, including evaluation and treatment, using modalities such as exercise, heat, water, electricity, ma...Show moreLast updated: 30+ days ago
    • Promoted
    Telemedicine Physician

    Telemedicine Physician

    QuickMDSilver Springs, NV, US
    Full-time
    QuickMD is a leading telemedicine provider, delivering high-quality virtual care across 44 states.Since our founding in 2019, we have helped more than 100,000 patients access essential medical trea...Show moreLast updated: 30+ days ago
    • Promoted
    Certified Diabetes Educator

    Certified Diabetes Educator

    Phoenix Children'sCold Springs, NV, United States of America
    Full-time
    This position develops, implements, and evaluates proactive patient educational plans and programs to address patient care needs in accordance with established best practices, standards, requiremen...Show moreLast updated: 30+ days ago
    • Promoted
    U.S. Border Patrol Agent

    U.S. Border Patrol Agent

    U.S. Customs and Border ProtectionMogul, NV, US
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 7 days ago
    • Promoted
    Nurse Practitioner - Fallon NV

    Nurse Practitioner - Fallon NV

    MRG ExamsFernley, NV, US
    Part-time
    Nurse Practitioner (NP) – Veteran Disability Assessments.VA's disability benefits process.Review and analyze electronic medical records via a secure web portal. Accurately document exam findings and...Show moreLast updated: 8 days ago
    • Promoted
    Border Patrol Agent - Earn up to $30,000 in Recruitment Incentives

    Border Patrol Agent - Earn up to $30,000 in Recruitment Incentives

    U.S. Customs and Border ProtectionSilver Springs, NV, US
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 10 days ago
    • Promoted
    Border Patrol Agent

    Border Patrol Agent

    U.S. Customs and Border ProtectionStagecoach, NV, US
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 7 days ago
    • Promoted
    Athletic Trainer - Minden, NV

    Athletic Trainer - Minden, NV

    DORNReno, NV, US
    Part-time
    Part-Time Industrial Injury Prevention Specialist (Part-Time, 1099 Contractor) .DORN Companies is a leader in industrial injury prevention and ergonomics, dedicated to reducing workplace injur...Show moreLast updated: 30+ days ago
    • Promoted
    Air Interdiction Agent

    Air Interdiction Agent

    U.S. Customs and Border ProtectionHerlong, California, US
    Full-time +1
    Pilot CBP Air Interdiction Agent.Considering making an application for this job Check all the details in this job description, and then click on Apply. Air and Marine Operations (AMO), a component o...Show moreLast updated: 30+ days ago