Senior Casualty Litigation Claim Specialist
The Auto Club Group, Lansing, Michigan, United States
Overview
It's a great time to join AAA The Auto Club Group! JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type:
Full time Exempt/Non Exempt:
Exempt/Non Exempt Job Description:
Senior Claim Specialist Casualty - The Auto Club Group Report to:
Claim Manager II
Responsibilities
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.
Handle large loss injury claims.
Ensure all possible policyholder benefits are identified.
Create additional sub-claims if needed.
Complete an investigation of the facts regarding the claim to 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.
Note:
Senior Claim Specialists are assigned Liability/BI/MedPay/Non-MI, PIP/HO Liability/UM/UIM claims involving litigation/arbitration. They handle the most complex claims involving liability disputes, bodily injuries, and coverage questions.
Benefits How you will benefit:
Senior Claim Specialist will earn a competitive salary of
$80,000 to $95,000
annually with annual bonus potential based on performance.
Excellent and comprehensive benefits packages are provided, including:
401k Match
Medical
Dental
Vision
PTO
Paid Holidays
Tuition Reimbursement
Qualifications Required Qualifications (minimum requirements)
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 the ACG 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 it as specified for the appropriate states.
Must have a valid State Driver's License
Experience:
Five years of experience in the following areas: 1st and 3rd party auto injury, homeowner liability, personal injury, and umbrella policies
Managing and handling claims where litigation or arbitration has been filed
Working with defense counsel
Multi-state claim/venue knowledge
Resolving complex coverage questions
Large loss claims
Negotiation of complex claim settlements
Securing and evaluating evidence and claims supports
Comfort with multi-system and software program usage
Subrogation claims and investigation
Taking statements
Establishing clear evaluation and resolution plans for claims
Knowledge and Skills:
Advanced technical knowledge of the Essential Insurance Act (Michigan)
Fair Trade Practices Act as it relates to claims
Subrogation procedures and processes
Microsoft products
Intercompany arbitration
Litigation
Large Loss
Coverage
Medical terminology
Advanced technical knowledge of negligence law, No-Fault law, medical terminology and human anatomy, Insurance Policy Review and Understanding, Coverage Review and letter writing
Ability to:
Handle claims according to the established Claim Handling Standards
Follow and apply ACG Claim policies, procedures, and guidelines
Work within the 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 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
Safely operate a motor vehicle to attend meetings off-site
Travel outside of the assigned territory, which may involve overnight stay
Relocate, work evenings or weekends
Work Environment 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.
About Us The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
AAA is committed to an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints.
To learn more about AAA The Auto Club Group visit www.aaa.com
Important Note: ACG's compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay. Pay ranges are based on geographic areas and other factors as associated with the job and job level. Salary at time of offer is determined accordingly.
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 for the function of this job. Any required background and drug screen processes will be conducted as per position requirements.
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It's a great time to join AAA The Auto Club Group! JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type:
Full time Exempt/Non Exempt:
Exempt/Non Exempt Job Description:
Senior Claim Specialist Casualty - The Auto Club Group Report to:
Claim Manager II
Responsibilities
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.
Handle large loss injury claims.
Ensure all possible policyholder benefits are identified.
Create additional sub-claims if needed.
Complete an investigation of the facts regarding the claim to 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.
Note:
Senior Claim Specialists are assigned Liability/BI/MedPay/Non-MI, PIP/HO Liability/UM/UIM claims involving litigation/arbitration. They handle the most complex claims involving liability disputes, bodily injuries, and coverage questions.
Benefits How you will benefit:
Senior Claim Specialist will earn a competitive salary of
$80,000 to $95,000
annually with annual bonus potential based on performance.
Excellent and comprehensive benefits packages are provided, including:
401k Match
Medical
Dental
Vision
PTO
Paid Holidays
Tuition Reimbursement
Qualifications Required Qualifications (minimum requirements)
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 the ACG 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 it as specified for the appropriate states.
Must have a valid State Driver's License
Experience:
Five years of experience in the following areas: 1st and 3rd party auto injury, homeowner liability, personal injury, and umbrella policies
Managing and handling claims where litigation or arbitration has been filed
Working with defense counsel
Multi-state claim/venue knowledge
Resolving complex coverage questions
Large loss claims
Negotiation of complex claim settlements
Securing and evaluating evidence and claims supports
Comfort with multi-system and software program usage
Subrogation claims and investigation
Taking statements
Establishing clear evaluation and resolution plans for claims
Knowledge and Skills:
Advanced technical knowledge of the Essential Insurance Act (Michigan)
Fair Trade Practices Act as it relates to claims
Subrogation procedures and processes
Microsoft products
Intercompany arbitration
Litigation
Large Loss
Coverage
Medical terminology
Advanced technical knowledge of negligence law, No-Fault law, medical terminology and human anatomy, Insurance Policy Review and Understanding, Coverage Review and letter writing
Ability to:
Handle claims according to the established Claim Handling Standards
Follow and apply ACG Claim policies, procedures, and guidelines
Work within the 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 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
Safely operate a motor vehicle to attend meetings off-site
Travel outside of the assigned territory, which may involve overnight stay
Relocate, work evenings or weekends
Work Environment 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.
About Us The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
AAA is committed to an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints.
To learn more about AAA The Auto Club Group visit www.aaa.com
Important Note: ACG's compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay. Pay ranges are based on geographic areas and other factors as associated with the job and job level. Salary at time of offer is determined accordingly.
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 for the function of this job. Any required background and drug screen processes will be conducted as per position requirements.
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