Job Description

Job Description

Our Claims team is currently seeking a Claims Adjuster experience in PIP and/or BI claims at our corporate location in Birmingham, MI.

This is a full time, hybrid role. A Michigan P&C Insurance License required.

POSITION OVERVIEW:

A Claims Adjuster will handle a caseload commensurate with the complexity level of claims assigned, including the following responsibilities: timely determining coverage and priority; investigating losses; assessing damages; reviewing, adjusting, and paying medical records and bills; supervising cases through litigation (if applicable); negotiating settlements; coordinating with authorized vendors for additional claims-related tasks, and assisting management or performing other miscellaneous claims adjustment duties as needed. A Claims Adjuster will ensure compliance with state and federal laws and regulations; company guidelines and file handling procedures; and best practice procedures. Travel may be required to perform some job duties.

IN THIS ROLE, YOU WILL:

• Handle all aspects of each claim using discretion and independent judgement, while maintaining productivity, confidentiality, and quality customer service.
• Take calls, check voice mail regularly, and return calls as needed.
• Contact claimants and insureds within 24 business hours of a claim assignment.
• Communicate with, explain benefits to, and answer questions from claimants, insureds, medical providers, and other potential parties to a claim via telephone and email.
• Maintain regular claims-related correspondence with claimants and insureds throughout the life of the claim or file as appropriate using telephone, email, and physical mail.
• Assess claims for coverage, validity, liability, exposure, subrogation, and potential paths to resolution.
• Coordinate with medical providers, educational institutions, claimants’ employers and company-approved vendors and specialists to investigate claims and gather relevant information regarding employment, education, medical history and treatment, etc. as appropriate.
• Review medical records and bills; assess and issue determinations on claims for medical bills and other no-fault benefits.
• Take recorded statements from insureds, claimants, and witnesses.
• Coordinate with the legal department and outside counsel to supervise claims in litigation, if applicable.
• Negotiate settlements within approved authority and policy limits.

WHAT YOU NEED TO APPLY:

• Michigan Insurance Adjuster’s License Required. CPCU certification preferred.
• Knowledge of Michigan No-Fault Insurance and Claims Handling, including relevant laws and regulations.
• At least two years’ experience as a claims adjuster. Five or more years’ experience preferred.
• Bachelor’s Degree or equivalent education.
• Proficiency in Microsoft Word, Excel, and Outlook, as well as Adobe Acrobat.
• Good written and verbal communication skills, including via telephone, email, and instant messaging. A strong candidate will promote and facilitate free and open communication and collaborative planning and decision-making.
• Excellent organizational and time management skills
• Strong customer service skills, including via telephone and email.
• Critical thinking and negotiation skills, including the ability to timely identify problems and develop solutions.

This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.

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