Claim Specialist - Michigan PIP (Insurance)

Location: Hybrid in Michigan, United States; Monday-Friday, 8am-5pm Eastern Time. Remote work from a home office is available for day-to-day operations, with occasional travel for meetings, collaboration, inspections, and other business activities.

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

Company

hirify.global provides membership, travel, insurance, and financial services to approximately 14 million members and customers across 14 states and two U.S. territories.

What you will do

• Evaluate intermediate to complex Michigan Personal Injury Protection claims, coverage applicability, policy benefits, damages, limits, exclusions, and recovery opportunities.
• Investigate claims involving fractures, mild closed head injuries, surgical procedures, attendant care, MCCA, attorney representation, and losses beyond standard PIP scenarios.
• Review medical records, claim facts, state laws, and other evidence to make accurate coverage and payment determinations.
• Authorize claim payments, negotiate settlements, establish sub-claims, and develop resolution plans.
• Communicate with insureds, claimants, attorneys, physician offices, medical providers, insurance carriers, and internal specialist departments.
• Document, code, manage, and close claims in accordance with company procedures, regulations, and claim handling standards.

Requirements

• Three years of experience or equivalent training in claim settlement negotiation, evidence evaluation, estimating, subrogation, coverage analysis, statement taking, and claim resolution planning.
• Completion of the ACG Claim Representative Training Program or equivalent knowledge and experience.
• Advanced knowledge of Michigan Essential Insurance, Fair Trade Practices, subrogation, intercompany arbitration, negligence, and No-Fault laws.
• Knowledge of medical terminology, human anatomy, MCCA claims, attorney-represented claims, and simple litigation.
• Eligibility to obtain a required state adjuster's license within 90 days of hire and maintain it as required.
• A valid driver's license is required when the role involves in-person inspections or frequent meetings; occasional travel, evenings, or weekends may be required.

Nice to have

• Bachelor's degree or equivalent in Business Administration, Human Resources Management, or a related field.
• Associate degree or equivalent experience in Business Administration, Insurance, or a related field.
• General Insurance Program, Associate in Claims, Associate in Management, CPCU coursework, or equivalent certification.

Culture & Benefits

• Hybrid work arrangement with home-office support for day-to-day operations.
• Medical, prescription, dental, vision, HSA, FSA, life, disability, critical illness, accident, and pet insurance options.
• 401(k) plan with company matching and additional company contributions.
• Paid time off, company holidays, mental health and floating holidays, volunteer time, and paid leave programs.
• Tuition assistance, professional certification reimbursement, career development opportunities, AAA membership, and adoption assistance.