Claims Specialist

• Provide quality assistance to adjusters throughout the claim lifecycle
• Respond to inquiries from policyholders, claimants, injured persons, medical providers and other stakeholders
• Gather and verify missing or incomplete information to support accurate claim processing
• Prepare and submit state filings, closing documents and administrative support requests
• Draft and distribute correspondence in accordance with company standards and regulatory requirements
• Enter data into the claims management system and maintain complete, accurate claim records
• Coordinate external vendors, including appraisers, attorneys and contractors
• Review and issue payments and invoices according to company policies and adjuster direction
• Provide medical providers with billing instructions, EOBs and payment information
• Explain coding and documentation denials and reconsideration processes
• Assist with reimbursement capture from the MCCA for claims exceeding retention
• Obtain HIPAA forms and order medical records for claim files
• Handle incoming calls and mail for the claims department

Claims Associate Adjuster – PIP

• Provide feedback, training, and educational material to claim associates throughout the operating states from a Home Office setting
• Review and monitor open claims files
• Provide assistance with coverage, liability, and damage determinations
• Review open and closed files to ensure adherence to claim handling guidelines and state Fair Claims Practices
• Assist with other duties within the regions or elsewhere on request
• Develop and present educational material to claim associates in classroom and remote settings
• Travel, attend meetings, seminars, and other training classes as required

Senior Claims Examiner – Bodily Injury

• Handle entry-level insurance claims under close supervision through the full claim lifecycle, including investigation, evaluation, and resolution
• Investigate, evaluate, and settle entry-level insurance claims
• Study insurance policies, endorsements, and forms to develop foundational knowledge of Company insurance products
• Learn and comply with Company claim-handling procedures
• Develop entry-level claim negotiation and settlement skills
• Serve agents, insureds, and other parties effectively
• Meet and communicate with claimants, legal counsel, and third parties
• Develop specialized skills, including estimating and using designated computer-based loss-adjustment programs
• Complete the Company’s claims training program for the assigned insurance line
• Study, obtain, and maintain adjuster licenses when required by statute, within Company or legal timelines

Claims Specialist jobs in Michigan

Claims Associate Adjuster – PIP

Senior Claims Examiner – Bodily Injury

Auto Claims Representative