• Senior PIP Specialist

    Location US-MI-Detroit
    Job ID
    36602
  • Summary

    Esurance is looking for a Senior Medical Specialist to join a dynamic and award-winning team of individuals who are committed to making insurance smarter, easier, and dare we say- cooler. As part of a growing company that is focused on providing an outstanding customer experience, you’ll have the opportunity to expand your skills and discover your potential.

     

    If you’re looking for a career at a socially conscious company that offers great benefits — including matching 401k and tuition reimbursement — then you may have just found your new home. 

     

    Esurance combines the spunk of a startup company with the backing of Allstate (the largest publicly held personal lines insurer in the U.S.) to create a unique, energized, and exciting place to work. 

     

    Responsibilities

    The Senior Medical Specialist resolves payment disputes on no-fault claims through negotiation and settlement or defense in a dispute resolution forum, consisting of binding arbitration or litigation in the court system (small claims, Civil, District and Supreme). The Senior Medical Specialist could also handle complex Michigan files where referrals to the Michigan Catastrophic Claims Association (MCCA) are required.

     

    This is the most senior level of the No fault department where representatives are responsible for handling claim actions independently. This position is responsible for assisting the unit manager in mentoring and training the newer reps on the team, and being well versed with applicable case law, arbitrator patterns, and all phases of both arbitration and lawsuits. This person generally handles the most difficult or largest exposure cases and has proven negotiation skills. In addition, they may be required to provide testimony on behalf of Esurance in a professional, mature, and accurate manner. This person attends large exposure and precedent setting hearings and understands macro issues and assists the leadership in developing and handling strategies.

     

     

    Job Responsibilities:

    • Uses various systems to locate prior losses, review policy coverage, document, and handles PIP claims of high complexity to
    • Works closely with defense attorney, analyzes statements, testimonies and develops a course of action with counsel to bring claim to a cost effective resolution.
    • Answers demands within the statutory time required.
    • Addresses diaries, correspondence, emails, and voicemail timely
    • Documents conversations and recorded statements with involved parties, including correspondences, bills and actions.  
    • Documents files and pays submitted bills according to procedures.
    • Sends correspondence and completes actions to satisfy department of insurance and/or state specific regulations
    • Provides technical expertise through formal and informal roundtable discussions.
    • Submits reports to underwriting regarding claims issues
    • Opens reserves appropriate to reflect exposure to the policy
    • Refers files to special investigation unit and assists with the investigation.
    • Authority level up to $50,000

     

    Qualifications:

    • Detail-oriented with strong organizational skills, able to work well under deadlines in a changing environment and perform multiple tasks effectively and concurrently.
    • Demonstrated ability to work effectively under pressure and within a collaborative team oriented environment using sound judgment in decision-making.
    • Excellent communication skills both oral and written with strong analytical skills.
    • Excellent customer service and negotiation skills
    • Demonstrated proficiency with Microsoft Office products (Excel, PowerPoint, and Word) and insurance software applications.
    • Demonstrated knowledge of personal injury protection statutes and medical payment coverages in various jurisdictions.
    • Demonstrated knowledge of litigation practices and processes.
    • Must be able to travel up to 20%

     

    Experience / Education:

    • Bachelor’s degree in related field or equivalent education preferred.
    • Minimum ten years of personal injury protection claims handling experience required with one year litigation and/or special investigation unit experience.

     

    Physical Demands and Work Environment:

    Representative of those that must be met by an employee to successfully perform the essential functions of this job. Must be able to operate a PC and sit for extended periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    Qualifications

    Benefits

    At Esurance, being committed to our employees is not just something we say, it’s something we do. Our benefits package is designed to help our associates stay healthy, meet their long-term financial goals, and balance the demands of work and personal life. Esurance rewards hard work, dedication, and creativity with competitive salaries and a generous bonus system. We are committed to our employees and we are dedicated to creating a diverse, positive, innovative and team-oriented work environment.

    Health & wellness

    • Medical, vision, and dental insurance
    • Life insurance (company-paid and supplemental)
    • Accidental death and dismemberment coverage
    • Wellness coaching and incentives
    • Group critical illness coverage
    • Accident indemnity and hospital indemnity plans
    • Group legal

    Savings

    • 401(k) plan with annual matching contribution
    • Referral bonuses
    • Performance-rewarding bonus system
    • Tuition assistance program (up to $5,250 per year)
    • Health savings and flexible spending accounts
    • Commuter benefits

    Family & Community

    • Adoption assistance
    • Maternity leave
    • Buckle Up Baby program
    • Pet insurance discount
    • Charitable gift matching
    • Give Time, Get Time volunteer program
    • Employee Assistance Program

    Time off

    • Short-term disability
    • Long-term disability (employee-paid option)
    • Paid time off (holidays, vacation, personal choice days)

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