Claims Adjuster (MI PIP & Med Pay)

Remote, USA Full-time
About the position The Claims Adjuster position focuses on managing Michigan Personal Injury Protection (PIP) and Medical Payments (Med Pay) claims. Under general supervision, the adjuster will utilize independent judgment to investigate, evaluate, and resolve claims, determining the extent of the company's liability. This role requires a thorough understanding of policy provisions and the ability to assess coverage, compensability, liability, and damages. The adjuster will follow standard procedures while adhering to corporate policies and fair claims handling practices. In this role, the adjuster will be responsible for obtaining necessary information to properly investigate each claim. This includes corresponding with agents, insureds, claimants, witnesses, and other relevant parties. The adjuster will review and evaluate documentation such as applications, reports, and statements to ensure a comprehensive understanding of each case. Additionally, the adjuster will monitor claim outcomes through a self-audit process to ensure compliance with legal and regulatory standards. Customer service is a critical aspect of this position, as the adjuster will deliver superior service to policyholders and agents, ensuring timely resolution of claims service issues. The adjuster will set or recommend reserves based on the investigation results and manage claims within defined authority, preparing and maintaining detailed claim reports. The role may involve extensive interaction with various stakeholders, including conducting in-depth interviews, scene inspections, and attending settlement conferences or trials. The adjuster may also participate in project teams, contributing to project objectives, and may provide leadership and training to junior staff, offering input on their performance to management. Other duties may be assigned as necessary. Responsibilities • Investigates claims to determine validity and extent of liability. , • Obtains information necessary to properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses, and others. , • Reviews and evaluates documentation, including applications, reports, and statements. , • Monitors appropriate claim outcomes through self-audit process. , • Delivers superior customer service to policyholders and agents, ensuring appropriate and timely resolution of claims service issues. , • Ensures legal, regulatory, and fair claims handling compliance. , • Sets or recommends reserves based on results of claim investigation. , • Manages, evaluates, and concludes claims within defined authority. , • Prepares and maintains claim reports. , • Conducts in-depth interviews and/or scene inspections. , • Attends settlement conferences and/or trials. , • May serve as a member of project teams, contributing to the achievement of project objectives. , • May provide leadership to junior staff by training and providing guidance. Requirements • Two to four years related experience and/or training in claims adjusting or a related field. , • Associate's degree (A.A.) from a two-year college/technical school or equivalent combination of education and related experience/training. , • Ability to work legally in the United States; no visa sponsorship/support available. Nice-to-haves Benefits Apply Job! Apply tot his job
Apply Now

Similar Jobs

Field Claims Property Adjuster- Rapid City, SD

Remote, USA Full-time

Integration Architect (Workato Experience Required) - DynPro Inc.

Remote, USA Full-time

Integration Architect I (Remote)- Full-Time/Days

Remote, USA Full-time

Sr. Integration Architect, Agentforce Supply Chain

Remote, USA Full-time

Data & Integration Architect

Remote, USA Full-time

Senior Integration Architect ( Workato )

Remote, USA Full-time

CRM Integration Architect -III (Remote)

Remote, USA Full-time

[Remote] CRM Integration Architect III,Madison,WI,remote

Remote, USA Full-time

CRM Integration Architect-III (ServiceNow Implementor)

Remote, USA Full-time

[Remote] Director, Integration Architect/AI

Remote, USA Full-time

Experienced Remote Data Entry Specialist – Join blithequark's Dynamic Team for a Rewarding Career in Financial Data Management

Remote, USA Full-time

Biological Safety Specialist

Remote, USA Full-time

GIS IT Architect Utilities & Enterprise GIS at Remote

Remote, USA Full-time

Experienced Healthcare Customer Service Representative – Delivering Exceptional Patient Experiences through Empathetic Support and Innovative Solutions at blithequark

Remote, USA Full-time

Experienced Remote Customer Service and Data Entry Representative – Dynamic Career Opportunity in a Thriving Industry

Remote, USA Full-time

GCP Contact Center AI Developer

Remote, USA Full-time

RMA Technician, Amazon

Remote, USA Full-time

Experienced Customer Success Manager – Delivering Exceptional Service and Driving Business Growth in Supply Chain Sustainability

Remote, USA Full-time

Experienced Full Stack AV Support Specialist – Video Conferencing and Collaboration Solutions for Southwest Airlines' Remote Work Environment

Remote, USA Full-time

**Experienced Customer Service Representative – Work From Home Opportunity with arenaflex**

Remote, USA Full-time
Back to Home