Claims PIP Adjuster

Overview

We are hiring a Claims Adjuster specializing in PIP, Med Pay, LTD, UM/UIM. Full-time with possible hybrid schedule. Benefits include Health, Dental, Vision, and 401k.

• Under minimal supervision, follow standard procedures with independent judgement:
  Investigate, evaluate, process to conclusion Michigan PIP, Indiana Med Pay, and BI/UM/UIM claims
• Obtain information necessary for determination of coverage, order for priority, compensability, liability, and related injuries or damages
• Monitor appropriate claim handling through self-audit process
• Set reserves based on claim evaluation and investigation
• Deliver superior customer service to policyholders and agents
• Work with MCCA and attorney-represented claims
• Work with Review Works on assigned claims, contact insured and other involved parties, explain claim process, coverage/benefits available, and initiate documentation to parties

• 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 exhibiting understanding of their problems and promptly responding to questions and concerns
• Communicate clearly with insureds, claimants, nurse case managers, medical providers and appraisers to keep all parties informed and address 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
• Research, analyze, and interpret subrogation laws in various states

• 3 to 5 years related experience
• Knowledge/
  
  Skills:
  
  Michigan No-Fault Law, Negligence Law, Essential Insurance Act, Fair Trade Practices Act, subrogation procedures and processes, intercompany arbitration, handling non-complex litigation, basic medical terminology and human anatomy, MCCA and attorney-represented claims

• Mid-Senior level

• Full-time

• Finance and Sales

• Insurance