Claim Representative II - Auto

Compensation:
Competitive Compensation and Benefits Package

AF Group’s focused and passionate team uses industry-leading best practices, analytics and resources to manage risk and minimize loss for our policyholders while strengthening businesses with our valued independent agent partners.

We strive to continuously increase the long-term value of our organization by outperforming our industry peers and fostering a culture of underwriting and claims excellence.

This is the intermediate level of the claims handling career path responsible for managing a caseload of Michigan No-Fault Personal Injury Protection (PIP) claims of ...

Job Description

The position requires thorough knowledge of Michigan No-Fault law, including order of priority investigations, coverage verification, injury causation analysis, and ...

Compensation

Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other ...

Claims

Determines compensability under Michigan Assigned Claims Plan and the Michigan No Fault Act by a thorough investigation of the claim. Documents specifics of ...

Management

Works closely with manager on complex files or files above settlement/reserve authority. Actively participates in agent/client relationship management. Manages medical ...

Quality Assurance

Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits. Manages outside vendors to ensure cost ...

Support

Exercises independent judgment to settle cases prior to mediation or litigation. Establishes and maintains effective working relationships with all internal and external ...

Compliance

Concludes and closes files following resolution of claims to meet internal and client directives performance standards while complying with state legislation to avoid ...

Skills

Bilingual skills preferred. Effective customer service skills. Ability to negotiate, build consensus and resolve conflict. Ability to solve complex problems. Ability to work ...

Education

Relevant combination of education and MACP claim handling experience may be considered, in lieu of degree. Certification or progress toward certification is highly ...

Experience

Three years’ experience in handling MCAP claims in an environment which provides the necessary skills, knowledge and abilities, such as experience in reviewing ...

Knowledge

Knowledge of medical and legal terminology related to the work. Knowledge and handing of Michigan Assigned Claims Plan and Michigan Automobile No Fault ...

AF Group’s focused and passionate team uses industry-leading best practices, analytics and resources to manage risk and minimize loss for our policyholders while strengthening businesses with our valued independent agent partners.

We strive to continuously increase the long-term value of our organization by outperforming our industry peers and fostering a culture of underwriting and claims excellence.

AF Group (Lansing, Mich.) and its subsidiaries are a premier provider of innovative insurance solutions. Insurance policies may be issued by any of the following companies within AF Group:
Accident Fund Insurance Company of America, Accident Fund National Insurance Company, Accident Fund General Insurance Company, United Wisconsin Insurance Company, Third Coast Insurance Company, or Comp West Insurance Company.

Company:
AF Group

Location:

United States, USA

Level:
Non-Manager

Compensation:
Competitive Compensation and Benefits Package

Job Family:
Claims Processing

Industry:
Insurance Services

This is the intermediate level of the claims handling career path responsible for managing a caseload of Michigan No-Fault Personal Injury Protection (PIP) claims of moderate to high complexity. The Claim Representative II investigates and administers both litigated and non-litigated PIP claims, exercising independent judgment in coverage analysis, compensability determinations, exposure evaluation, and claim resolution. The position requires thorough knowledge of Michigan No-Fault law, including order of priority…