PIP Claim Specialist (Insurance)

Location: Hybrid in Michigan, United States; remote work from a home office is available for day-to-day operations, with occasional travel for meetings, collaborative activities, inspections, and team building. Schedule: Monday-Friday, 8:30am-5:30pm Eastern Time.

Annual salary: $67,317.20-$104,811.20, plus potential annual company bonus incentive.

Company

AAA – The Auto Club Group provides membership, travel, insurance, financial services, and roadside assistance to members and customers across 14 states and two U.S. territories.

What you will do

• Manage Michigan PIP intermediate claims involving fractures, mild closed head injuries, surgical procedures, attendant care, and other complex losses.
• Review claims, contact insureds and affected parties, set expectations, and document claim activity in the claims management system.
• Investigate claim facts, analyze coverage, applicable limits and exclusions, recovery potential, damages, and state-law requirements.
• Evaluate financial loss values, approve appropriate payments, create sub-claims, and refer cases to underwriting, recovery, or special investigation units when necessary.
• Work with insureds, physicians’ offices, medical insurance carriers, the MCCA, and attorneys to obtain information and resolve claims.
• Document and code claim files, complete closure activities, and negotiate settlements in line with claim-handling standards.

Requirements

• Three years of 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 and experience.
• Eligibility to obtain a state adjuster’s license within 90 days of hire where required.
• Advanced knowledge of Michigan insurance requirements, the Essential Insurance Act, Fair Trade Practices Act, subrogation, intercompany arbitration, negligence law, no-fault law, medical terminology, human anatomy, MCCA, and attorney-represented claims.
• Strong investigation, analysis, decision-making, communication, customer service, negotiation, organization, and time-management skills.
• Valid driver’s license and ability to safely operate a vehicle for inspections or meetings; ability to travel outside the assigned territory, potentially overnight.

Nice to have

• Associate degree in Business Administration, Insurance, or a related field.
• Insurance Institute of America General Insurance Program, Associate in Claims, Associate in Management, CPCU coursework, or equivalent certification.

Culture & Benefits

• Full-time employment with paid time off, paid sick leave, company holidays, mental health and volunteer days, and paid parental, bereavement, jury duty, and military leave.
• Medical, prescription, dental, vision, HSA, FSA, and Employee Assistance Program benefits.
• Company-paid basic life insurance, disability coverage, and optional supplemental insurance programs.
• 401(k) plan with company matching and additional company contributions.
• Tuition assistance of up to $5,250 annually and 100% reimbursement for eligible professional certification programs.
• Complimentary AAA membership, roadside assistance, travel discounts, and adoption assistance.

Hiring process

• Employment is subject to a background check and drug screening.