Claims Examiner

Who We Are

The Michigan Catastrophic Claims Association (MCCA) is a private, non-profit association that serves as the state’s reinsurer for auto insurance companies. Since its creation in 1978, the MCCA has been a model of financial stability and success, allowing insurance companies to provide generous no-fault coverage that pays for medical care of those who have been catastrophically injured in car crashes. Thousands of Michigan families depend on the MCCA’s ability to reinsure their catastrophic injury claims.

The MCCA has a core team of dedicated, experienced individuals and is looking for candidates who want a collaborative environment that allows them to use and improve their skills. The MCCA is committed to the principles of equal opportunity in its recruitment, hiring, training, and promotions of its employees. 

The Right Candidate

The MCCA is seeking a detail-oriented and empathetic Claims Examiner to join our team. The ideal candidate will have strong communication, problem-solving, and negotiation skills, along with a deep understanding of insurance policies and regulations. If you thrive in a dynamic team environment, and are able to manage multiple complex tasks efficiently, we want to hear from you!

What We Offer

In addition to a competitive salary, we offer flexible hours, opportunities for remote work, and a strong benefits package.

We’d love to speak with you about joining our team today!

Reviews claims from member insurance companies to ensure proper claims management practices are followed in accordance with Michigan’s No-Fault law and MCCA policies and procedures. Determines reserve amounts for assigned claims. Works closely with member insurance companies to ensure compliance with reporting policies and procedures throughout the lifetime of the claim.

1. Reviews and approves requests for reimbursement on more stable claim files. Gathers supporting documentation for assigned claim files. Determines reserve amounts for claims in accordance with MCCA policies and procedures.
2. Approves less complex requests for authority from member companies. Consults with Claims Supervisor on moderately complex or escalated requests for authority.
3. Evaluates, monitors, and resolves ongoing requests for reimbursement and review semi-annual claim status reports prepared by member carriers. Responds to questions related to claim status, Association procedures, and other matters. Ensures claims are paid in accordance with Michigan no-fault law.
4. Actively participates in continuing education and training. Remains abreast of changes in Michigan No-Fault Law.
5. Proactively assists member companies with compliance with MCCA claims procedures and practices, including MMS based and on-site audits of carrier claims files as needed.
6. Attends and participates in Claim Committee meetings as necessary.
7. Assists with mail, fax, scanning when needed.
8. Participates with system testing and end user support.

An employee in this position may be called upon to do any or all of the above tasks. (These examples do not include all of the tasks which the employees may be expected to perform.)

Education

§ Bachelor’s Degree preferred.

Experience

§ Experience in the insurance industry preferred.

Other Requirements

§ Proficiency in the use of common office software, including electronic spreadsheets, word processing programs, and e-mail systems required.

The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job-related selection or promotional criteria.

Physical Requirements (This job requires the ability to perform the essential functions contained in this description. These include, but are not limited to, the following requirements. Reasonable accommodations will be made for otherwise qualified applicants unable to fulfill one or more of these requirements.)

§ Ability to enter and retrieve information from a computer.

§ Ability to travel to and from member sites to perform claim file audits.

§ Ability to lift and carry files, laptop, and other materials.

§ Ability to travel to various sites.

Working Conditions

§ Works in an office environment, primarily remotely.

§ Travels to various sites to attend meetings.

§ May be required to travel to various sites to conduct file audits.