Senior Claim Specialist- Bodily Injury; Litigation

Overview

Senior Claim Specialist
- Bodily Injury (Litigation) in Michigan. This position is hybrid remote with location-based requirements and potential travel as determined by leadership. Reside in the State of Michigan.

• 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.
• Investigate the facts regarding the claim to determine if the claim should be paid, 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).
• Document and code the claim file and complete all claim closure and related activities in the assigned claims management system.
• Utilize strong negotiating skills.

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, 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 involve conducting in-person inspections or frequent in-person meetings with members

Experience

• Five years of experience in negotiation of complex claim settlements, securing and evaluating evidence, preparing manual and electronic estimates, subrogation claims, resolving complex coverage questions, taking statements, and 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
• Teamwork orientation

Advanced technical knowledge of

• Negligence Law
• No-Fault Law
• Medical terminology and human anatomy
• Attorney represented claims

Ability

• 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 understanding their problems and responding to questions and concerns
• Analyze and solve problems with sound critical thinking and decision-making
• 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

This is a hybrid work arrangement (time spent in office and remote). Some employees may come to an ACG facility weekly, monthly, or as needed for key meetings and collaborative activities; most will be required to come in for important departmental meetings or teambuilding events.

EEO/Disclaimer:
The Auto Club Group is an equal opportunity 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. Regular and reliable attendance is essential. Background and drug screening may be required based on the position.