Adjuster PIP - Consultant Casualty Claims

Our Claims team is currently seeking an Adjuster PIP - Consultant Casualty Claims.

This is a full-time, exempt role with a hybrid work schedule (two days in the office) in one of our Hanover offices:

• Howell, MI
• Southfield, MI
• Grand Rapids, MI

POSITION OVERVIEW:

The Consultant Casualty Claimsis responsible formanagingno-fault claims that typically involve minimal to moderate injury and disability severity.

Duties include verifying coverage, evaluating medical bills and applicable no-fault benefits for payment, andmaintainingclear communication with claimants, third parties and providers. Claims may also involve negotiating settlements, handling of basic disputes, and/or arbitration.

IN THIS ROLE, YOU WILL:

• Manage a caseload of moderately complex casualty claims from intake through resolution.
• Conduct thorough investigations, assess liability, and evaluate damages using established procedures.
• Collaborate with underwriting, legal, and internal/external stakeholders as needed to ensure comprehensive claim evaluation.
• Identify and refer potentially suspicious claims to the Special Investigations Unit.
• Apply comparative negligence laws and state-specific regulations to claim assessments.
• Set reserves, authorize payments, and demonstrate financial acumen withinscopeof authority.
• Utilize technology and data tools to enhance claims processing efficiency and accuracy.
• Communicate directly with claimants, legal representatives, and third parties to negotiate fair resolutions.
• Maintain detailed and compliant documentation of claim activities and communications.
• Participate in team collaboration, problem-solving discussions, and cross-functional coordination.
• Support subrogation efforts and risk transfer opportunities to benefit insureds and business partners.
• Handle sensitive communications professionally and translate complex information for diverse audiences.
• Mentor entry-level claim handlers and share best practices learned through training and experience.
• Attend ongoing training and education to maintain licensing and stay current on industry standards.
• Independently manage indemnity, medical, and basic arbitration or mediation components of claims with supervisory support.
• Must possessor obtain andmaintainappropriate state adjuster licenses.

Core Capabilities:

• Analytical Reasoning:The ability toidentifyproblems, understand your impact, gather input and data, and develop an effective solution.
• Customer Centricity:Makes customers/clients and their needs a primary focus of one’s actions; shows interest in and understanding of the needs and expectations of internal and external customers; gains customer trust and respect; meetsorexceedscustomer expectations.
• Digital Fluency:Effectively uses digital tools and technology appropriately to find, evaluate, create, and communicate information understands how to navigate digital platforms, use software applications, and leverage technology for productivity and communication purposes.
• Persuasion and Influence:Uses appropriate interpersonal skills and techniques to gain acceptance for ideas or solutions; uses influencing strategies to gain genuine agreements;seeksto persuade rather than force solutions or impose decisions or regulations.
• Professional Insurance Acumen:Demonstratesadeepeningunderstanding of the insurance industry and the ability to apply specialized technical skills to address complex challenges, adapt to industry trends, and drive value for the organization.
• Planning and Execution:Plans, prioritizes and manages resources and time effectively to achieve specific goals or deadlines.