Senior Claim Specialist

AAA

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

Posted 11/5/2026full-timeMichigan • United StatesSenior💰 $76,700 - $119,434 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates advanced knowledge of insurance claims processes, including negotiation, coverage analysis, and subrogation procedures. Proficient in evaluating claims, applying relevant laws, and maintaining compliance with claim handling standards.

Highest-signal resume keywords

Advanced Knowledge Of The Essential Insurance ActAdvanced Knowledge Of The Fair Trade Practices ActNegotiation Of Claim SettlementsClaim Evaluation And Resolution PlansAbility To Handle Michigan PIP Claims

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims Management SystemCoverage AnalysisSubrogation ProceduresMedical TerminologyClaim File ReviewInvestigation SkillsTime-Sensitive Data ProcessingClaim DocumentationFinancial Value EvaluationClaim Closure Activities

Soft Skills

Effective Verbal CommunicationEffective Written CommunicationCustomer Service SkillsRelationship-Building SkillsProblem-Solving SkillsDecision-Making SkillsTime Management SkillsOrganization SkillsWorkload Planning Skills

Tools & Technologies

Basic PC SoftwareClaims Handling Systems

Certifications & Qualifications

State Adjuster’s LicenseCompletion Of ACG Claim Representative Training ProgramCompletion Of The Insurance Institute Of America's General Insurance ProgramCPCU Coursework Or Designation

Industry Keywords

Michigan PIP ClaimsMCCANegligence LawNo-Fault LawSubrogation LawsIntercompany ArbitrationCatastrophic InjuriesClaim Handling StandardsInsurance Claims

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 the applicability of state law and other claim-related 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 resolutions
Handle Michigan PIP claims involving MCCA, quadriplegic, traumatic brain, amputation, and other catastrophic injuries
Work with insureds, guardians, conservators, attorneys, treatment teams, and case managers to obtain information and complete claim reviews
Make appropriate claim determinations
Travel for occasional meetings, collaborative activities, team building, inspections, or other assigned activities as specified by leadership

Requirements

What you’ll need

Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
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 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)
Advanced knowledge of the Fair Trade Practices Act as it relates to claims
Advanced knowledge of subrogation procedures and processes
Advanced knowledge of intercompany arbitration
Advanced knowledge of handling simple litigation
Advanced knowledge of Negligence Law, No-Fault Law, and No-Fault Reform
Advanced knowledge of medical terminology and human anatomy
Advanced knowledge of MCCA and attorney represented claims
Ability to handle claims to Claim Handling Standards
Ability to follow and apply ACG Claim policies, procedures, and guidelines
Ability to work within assigned ACG Claim systems and basic PC software
Basic claim file review and investigation skills
Effective verbal and written communication skills
Customer service and relationship-building skills with insureds and claimants
Problem-solving and sound decision-making skills
Ability to prioritize claim-related functions
Ability to process time-sensitive data and information from multiple sources
Time management, organization, and workload planning skills
Ability to safely operate a motor vehicle to visit repair facilities, homes, patients, and other locations
Ability to research, analyze, and interpret subrogation laws in various states
Ability to travel outside assigned territory, potentially with overnight stays
Ability to relocate and work evenings or weekends
Preferred: Associate degree in Business Administration, Insurance, or a related field, or equivalent related work experience
Preferred: Completion of the Insurance Institute of America's General Insurance Program, Associate in Claims, Associate in Management, or equivalent
Preferred: CPCU coursework or designation

Benefits

Comp & perks

Annual company bonus incentive
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 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
Career development and advancement opportunities
Complimentary AAA membership with roadside assistance and travel discounts
Adoption assistance program
Remote work from a home office for day-to-day operations, subject to ACG Flex Work policy