Claim Specialist – Michigan PIP

Location: Hybrid in Michigan, United States; Monday-Friday, 8am-5pm Eastern Time. Day-to-day operations may be performed remotely from a home office, with occasional travel for meetings, collaborative activities, team building, inspections, or visits outside the assigned territory.

Annual salary: $67,371.20-$104,811.20, plus potential annual company bonus incentive.

Company

hirify.global provides membership, travel, insurance, and financial services to members and customers across 14 states and two U.S. territories through AAA, Meemic, and Fremont brands.

What you will do

• Review and investigate assigned claims, gather statements and evidence, and document all claim activity in the claims management system.
• Perform complex coverage analysis, determine applicable benefits, policy limits, exclusions, recovery opportunities, and claim validity.
• Handle intermediate to complex Michigan PIP claims involving fractures, mild closed head injuries, surgical procedures, attendant care, MCCA, and attorney representation.
• Evaluate losses, authorize appropriate payments, negotiate settlements, and establish clear claim resolution plans.
• Manage sub-claims and refer matters to Underwriting, Recovery Units, or the Claims Special Investigation Unit when appropriate.
• Collaborate with insureds, claimants, attorneys, physician offices, medical providers, and insurance carriers while maintaining regulatory and company compliance.

Requirements

• At least three years of relevant experience or equivalent training in claim settlement negotiation, evidence evaluation, estimates, subrogation, coverage questions, statements, and claim resolution planning.
• Completion of the ACG Claim Representative Training Program or equivalent knowledge or experience.
• Eligibility to acquire a state adjuster’s license within 90 days of hire where required.
• Advanced knowledge of Michigan Essential Insurance and Fair Trade Practices Acts, Michigan No-Fault Law, negligence law, subrogation, intercompany arbitration, medical terminology, human anatomy, MCCA, and attorney-represented claims.
• Strong communication, customer service, analytical, problem-solving, negotiation, organization, and decision-making skills.
• A valid driver’s license is required when responsibilities include in-person inspections or frequent meetings; ability to travel, work occasional evenings or weekends, and safely operate a motor vehicle is required.

Nice to have

• Bachelor’s degree or equivalent in Business Administration, Human Resources Management, or a related field.
• Associate degree in Business Administration, Insurance, or a related field.
• Insurance Institute of America program, Associate in Claims, Associate in Management, CPCU coursework, or CPCU designation.

Culture & Benefits

• Medical, prescription, dental, vision, HSA, FSA, employee assistance, life insurance, disability, and supplemental insurance options.
• 401(k) plan with company matching and additional company contributions.
• Paid time off, paid holidays, mental health, floating, volunteer, parental, bereavement, jury duty, and military leave programs.
• Tuition assistance of up to $5,250 annually and professional certification reimbursement.
• AAA membership with roadside assistance and travel discounts, plus adoption assistance.