Senior Claim Specialist

AAA

. Review assigned claims and contact insureds and other affected parties .

Posted 9/28/2026full-timeMichigan • United StatesSenior💰 $76,700 - $119,434 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates advanced knowledge of Michigan insurance laws, including the Essential Insurance Act and No-Fault Law, while effectively managing claims through negotiation, documentation, and compliance with claim handling standards. Proficient in evaluating complex claims, conducting investigations, and maintaining strong relationships with insureds and stakeholders.

Highest-signal resume keywords

Claim Settlement NegotiationAdvanced Knowledge of Essential Insurance ActExperience with Michigan PIP ClaimsAbility to Obtain State Adjuster’s LicenseEffective Verbal and Written Communication Skills

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims ReviewCoverage AnalysisClaims DocumentationSubrogation ProceduresClaims Management SystemFinancial Loss EvaluationClaim DeterminationInvestigation of Claim FactsClaims Closure ActivitiesBasic PC Software Proficiency

Soft Skills

Customer Service SkillsProblem-Solving SkillsTime Management SkillsOrganizational SkillsRelationship Building

Certifications & Qualifications

State Adjuster’s LicenseCompletion of ACG Claim Representative Training ProgramCPCU Coursework or DesignationAssociate in ClaimsCompletion of Insurance Institute of America's General Insurance Program

Industry Keywords

Michigan PIP ClaimsNo-Fault LawNegligence LawFair Trade Practices ActIntercompany ArbitrationClaim Handling StandardsMCCATraumatic Brain InjuriesQuadriplegic InjuriesCatastrophic Injuries

About the role

Key responsibilities & impact

Review assigned claims and contact insureds and other affected parties
Set expectations for the remainder of the claim process and initiate documentation in the claim handling system
Complete complex coverage analysis and identify all possible policyholder benefits
Create additional sub-claims when needed
Investigate claim facts to determine payment, applicable limits or exclusions, and recovery potential
Review damages and determine applicability of state law and other claim factors
Evaluate the financial value of losses
Approve payments for appropriate parties
Refer claims to Underwriting, Recovery Units, Claims Special Investigation Unit, or other company units when necessary
Thoroughly document and code claim files and complete claim closure activities in the claims management system
Negotiate claim settlements
Handle Michigan PIP claims involving MCCA, quadriplegic injuries, traumatic brain injuries, amputations, and other catastrophic injuries
Work with insureds, guardians, conservators, attorneys, treatment teams, and case managers to obtain necessary information and complete claim reviews
Make appropriate claim determinations

Requirements

What you’ll need

Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
Must be eligible to acquire a State Adjuster’s license within 90 days of hire where required and maintain it as specified
Valid driver's license required if primary responsibilities involve in-person inspections or frequent in-person meetings
Five years of experience or equivalent training in negotiation of claim settlements, securing and evaluating evidence, preparing manual and electronic estimates, subrogation claims, resolving coverage questions, taking statements, and establishing claim evaluation and resolution plans
Advanced knowledge of the Essential Insurance Act (Michigan)
Knowledge of the Fair Trade Practices Act as it relates to claims
Knowledge of subrogation procedures and processes
Knowledge of intercompany arbitration
Knowledge of handling simple litigation
Advanced knowledge of Negligence Law, No-Fault Law, No-Fault Reform, medical terminology and human anatomy, MCCA, and attorney-represented claims
Ability to handle claims to Claim Handling Standards and apply ACG Claim policies, procedures, and guidelines
Ability to work within assigned ACG Claim systems and basic PC software
Ability to perform basic claim file reviews and investigations
Effective verbal and written communication skills
Customer service skills and ability to build and maintain relationships with insureds and claimants
Problem-solving and sound decision-making skills
Ability to prioritize claim-related functions and process time-sensitive information from multiple sources
Time management, organization, and workload planning skills
Ability to safely operate a motor vehicle for visits to repair facilities, homes, patients, and other locations
Ability to research, analyze, and interpret subrogation laws in various states
Ability to travel outside the assigned territory, potentially with overnight stays
Ability to relocate and work evenings or weekends
Background and drug screen required for employment
Associate degree in Business Administration, Insurance, or a related field, or equivalent related work experience (preferred)
Completion of Insurance Institute of America's General Insurance Program, Associate in Claims, Associate in Management, or equivalent (preferred)
CPCU coursework or designation (preferred)

Benefits

Comp & perks

Medical plans with multiple coverage options, including HSA eligibility
Prescription drug coverage
Dental and vision benefits
Employee Assistance Program
Company-paid basic life insurance
Optional supplemental life insurance and dependent coverage
Short-term and long-term disability coverage
Critical illness, accident, and pet insurance options
401(k) plan
50% company match on employee contributions up to 6% of pay
Additional company contribution of 4% of pay each pay day; 100% vested after three years of service
Health Savings Account (HSA) and Flexible Spending Accounts (FSA) options
Paid Time Off (PTO), increasing with tenure
10 company-paid holidays annually for full-time employees
1 mental health day, 2 floating holidays, and 1 volunteer day for full-time employees
Paid leave programs, including parental, bereavement, jury duty, and military leave
Tuition assistance up to $5,250 annually; 80% covered by ACG
Professional certification support with 100% reimbursement for eligible programs
Opportunities for career development and advancement
Complimentary AAA membership with roadside assistance and travel discounts
Adoption assistance program
Annual company bonus incentive
Hybrid work arrangement with remote home-office work for day-to-day operations and occasional travel for meetings, collaborative activities, or team building