JOB REQUIREMENTS: It\'s a great time to join AAA The Auto Club Group! JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time Exempt/Non Exempt: Salary Job Description: Sr Claim Specialist - Medical Management Unit- The Auto Club Group What you will do: The Auto Club Group is seeking prospectiveSeniorClaim Specialistswho canwork under less supervision with a high-level of authority to handle highly complex technical issues and the most complex claims. In this position, you will have the opportunity to: Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system. Complete coverage analysis on the most complex claims. \Ensure all possible policyholder benefits are identified. \Create additional sub-claims if needed. Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. \Evaluate the financial value of the loss. \Approve payments for the appropriate parties accordingly. Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills. Senior Claims Specialists assigned to the PIP unit are responsible for claims involving the MCCA or quadriplegic, traumatic brain, amputations and other catastrophic injuries. The role will require proficiency in dealing with the MCCA and attorney represented claims. Work with insureds, physicians\' offices and medical insurance carriers to obtain necessary information to complete the claims review process and make the appropriate determinations. Work Environment This position is currently able to work remotely from a home... For full info follow application link. As an equal opportunity employer, ACG is committed to providing equal opportunity in all employment practices, including but not limited to: selection, hiring, assignment, re-assignment, promotion, transfer, compensation, evaluation, benefits, training and development, discipline and termination. The company prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, gender, sexual preference/orientation, marital status, pregnancy, childbirth or related medical conditions, age, disability or handicap, citizenship status, service member status, genetic information, or any other category protected by federal, state, or local law. Violation of this policy may result in disciplinary action including termination of employment. ** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/D2DC83B4F055406B

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SR Claim Specialist MMU