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Remote PIP Claim Specialist

AAA The Auto Club Group

This is a Contract position in Cleveland, OH posted November 27, 2022.

Job Description Remote PIP Claim Specialist – Meemic What You Will Do AAA The Auto Club Group is seeking a prospective PIP Claim Specialist who can 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, Contacting 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 injuries and determine the applicability of state law and other factors related to the claim.

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

The role will 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 How You Will Benefit Claim Specialist will earn a competitive salary of $60,700 to $67,500 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 Qualifications We’re looking for candidates who: 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, the candidate must be eligible to acquire a State Adjuster’s license within 90 days of hire and maintain as specified for appropriate states.

Must have a valid State Driver’s License Experience Three years of experience or equivalent training in the following: Michigan PIP 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 Advanced knowledge of: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims Subrogation procedures and processes Intercompany arbitration Handling simple litigation Advanced 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 work load and responsibilities Research analyze and interpret subrogation laws in various states Work evenings or weekends What It’s Like To Work For Us We serve our members by making their satisfaction our highest priority.

We do what’s right by sustaining an open, honest and ethical work environment.

We lead in everything we do by offering best-in-class products, benefits and services.

And we value our employees by seeking the best talent, rewarding high performance and holding ourselves accountable.

All in all, we create an inclusive and welcoming environment of diverse backgrounds, experiences and viewpoints, realizing our differences make us stronger.

Who We Are The Auto Club Group helps AAA Members enjoy life’s journey with peace of mind by providing innovative solutions, advocacy and membership benefits wherever and whenever they need them.

We currently conduct business in 14 states in the upper Midwest and the Southeast.

The Auto Club Group has established four long-term enterprise goals: Long-term, sustainable, profitable growth AAA Membership growth and renewal Operational excellence Become the “flagship club” of the AAA Federation Important Note ACG’s Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals.

ACG utilizes a geographic pay differential as part of the base salary compensation program.

Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates.

Salary at time of offer is determined based on these and other factors as associated with the job and job level.

The above statements describe the principle and essential functions, but not all functions that may be inherent in the job.

This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements.

Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfil these requirements.

The Auto Club Group, and all of its affiliated companies, 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.