Senior Claim Specialist

AAA

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

Posted 10/2/2026full-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 managing claims in compliance with state laws and ACG Claim policies while maintaining effective communication with insureds and stakeholders.

Highest-signal resume keywords

Advanced Knowledge Of Essential Insurance ActAdvanced Knowledge Of Fair Trade Practices ActNegotiation Of Claim SettlementsFive Years Of Claims ExperienceState Adjuster’s License Eligibility

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ReviewCoverage AnalysisSubrogation ProceduresClaim DocumentationClaims Management SystemFinancial Loss EvaluationClaim Settlement NegotiationMedical TerminologyInvestigation Of Claim FactsTime-Sensitive Data Processing

Soft Skills

Effective Communication SkillsCustomer Service SkillsProblem-Solving SkillsDecision-Making SkillsOrganizational Skills

Tools & Technologies

ACG Claim SystemsBasic PC Software

Certifications & Qualifications

State Adjuster’s LicenseACG Claim Representative Training Program

Industry Keywords

Michigan PIP ClaimsMCCANegligence LawNo-Fault LawIntercompany ArbitrationLitigation HandlingClaim Handling Standards

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 analyses and identify all possible policyholder benefits
Create additional sub-claims when needed
Investigate claim facts to determine payment eligibility, applicable limits or exclusions, and recovery potential
Review damages and determine 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, or the Claims Special Investigation Unit when necessary
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 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
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, including basic PC software
Ability to perform basic claim file review and investigations
Effective verbal and written communication skills
Customer service skills and ability to maintain relationships 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
Ability to manage time, organize, and plan workload and responsibilities
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 assigned territory, potentially involving overnight stays
Ability to relocate and work evenings or weekends
Background and drug screening required upon offer of employment

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
Up to 12 PTO days annually for full-time new employees
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
Remote work from a home office for day-to-day operations, subject to ACG Flex Work policy