Senior Casualty Litigation Claim Specialist

Overview

It s a great time to join AAA The Auto Club Group!

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Job Type: Full time

Exempt/Non Exempt: Exempt

Job Description: Senior Claim Specialist Casualty
- The Auto Club Group

Report to: Claim Manager II

What you will do:

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.

In this position, you will have the opportunity to:

• 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 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 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.

Senior Claim Specialists are assigned Liability/BI/Med Pay/Non-MI PIP/HO Liability/UM/UIM claims involving litigation/arbitration. The Senior Claim Specialists handle the most complex claims involving liability disputes, bodily injuries, and coverage questions.

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 just another reason to work for the Auto Club Group. Benefits include:
• 401k Match
• Medical
• Dental
• Vision
• PTO
• Paid Holidays
• Tuition Reimbursement

Required Qualifications (these are the minimum requirements to qualify)

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:
• 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
• 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,…