Claim Specialist

About the role

Michigan Personal Injury Protection claims are the core of the work, including catastrophic claims and attorney-represented cases. Decisions on coverage and payment are made with little supervision.

At a glance

What you will do

• Review assigned claims, open handling and contact insureds and other parties to gather facts.
• Run complex coverage analysis, investigate validity, limits and exclusions, and set up sub-claims.
• Value losses, authorize payments and negotiate settlements, referring cases to underwriting, recovery or the special investigation unit.
• Handle intermediate to complex Michigan PIP claims such as fractures, mild closed head injuries, surgeries and attendant care.
• Keep claim records, coding and closures accurate and compliant with state rules and company standards.

What they look for

• Three years of experience or equivalent training in claim settlement negotiation, evidence gathering, estimates, subrogation and coverage qu
• Completion of a claim representative training program, or equivalent knowledge and experience.
• Eligibility to get a state adjuster's license within 90 days where one is required, and a valid driver's license if inspections are part of

Nice to have

• Experience applying Michigan No-Fault reform regulations to claim handling and benefit decisions.
• A detail-focused approach to problem solving and sound judgment.