Claims Representative

Title: Multi-Line Property and Casualty Claims Representative

Reports To: Claims Manager

Location: East Lansing, MI

Department: Property/Casualty and Workers’ Compensation (PC/WC)

SET SEG is looking for a Multi-Line Property & Casualty Claims Representative who will be responsible for the investigation, negotiation, adjustment, and resolution of designated PC claims. This position reports to the Claims Manager. The Multi-Line Property and Casualty Claims Representative is responsible for the prompt, fair, and efficient handling of a diverse caseload of Property and Casualty claims across multiple lines including general liability, auto liability, auto physical damage, personal injury protection (PIP), property, medical payments and select specialty coverages. This role serves as a primary point of contact for members and plays a key role in delivering high-quality customer service through timely communication, sound judgment, and consistent adherence to organizational standards. The ideal candidate has strong technical claim knowledge, excellent communication skills and experience working with public entities and third-party vendors. This position requires independent judgment, strong documentation practices, and a customer-focused approach with the ability to balance efficiency with accuracy and compliance with applicable laws, regulations, and internal claims handling guidelines.

WHO WE ARE

School Employers Trust (SET) is a non-profit company that was created after a monumental shift in school funding happened in 1965. SET, which began in 1971, served as an employee benefits association focused on offering comprehensive and affordable employee benefit solutions to Michigan public schools and their employees. Two years later, its partner organization School Employers Group (SEG) was formed to administer compensation and fringe benefits for SET. As schools were faced with more challenges related to insurance, SEG evolved and grew into a company that provides workers’ compensation and property/casualty services for Michigan public schools.

Today, SET SEG continues to expand and find creative ways to meet the specialized needs of its members. This, coupled with a superior member experience, is why SET SEG has maintained its position as an industry leader in the school insurance market.

We value those who proactively solve challenges, simplify the complex, thrive in a fast-paced setting, have a customer-first mentality, and seek a collaborative and inclusive work environment. We are also listed on the Business Insurance Best Places to Work. We offer 100% employer paid insurance (medical, dental, and vision), Paid Time off (PTO), and paid parental leave.

Our passion is delivering peace of mind to Michigan public schools and we look for team members who are motivated by our cause. To learn more, visit: https://setseg.org.

WHO YOU ARE

You are energized by working with a collaborative team and industry peers to support Michigan public schools through their challenges. You seek understanding and are motivated to tackle projects and problems with the customer in mind. You anticipate needs and preempt challenges and concerns, delivering increasingly relevant customer experiences over time. You value a culture that is rooted in mutual respect, where you can learn from different perspectives and roles.

Primary Responsibilities:

• Investigate, evaluate, negotiate, and resolve assigned claims in compliance with applicable laws, regulations, and internal claims handling standards, with an emphasis on quality and consistency.
• Provide high-quality customer service in a fast-paced environment while serving as a primary contact for members.
• Maintain accurate, timely and well-organized documentation within the claims management system while managing multiple active claims concurrently.
• Deliver clear, accurate, and customer-friendly coverage explanations and written correspondence to help our members understand claim decisions and next steps.
• Negotiate claims within established settlement authority and promptly notify leadership of any claim trending toward or exceeding authority limits.
• Assign, coordinate, and monitor work performed by outside investigators, third-party vendors, law firms, and individual attorneys when assigned.
• Provides oversight of medical, legal damage estimates, and miscellaneous invoices to determine if they are reasonable and related to designated claims.
• Negotiates any disputed bills or invoices for resolution.
• Assigns litigated claims to approved law firms and/or individual attorneys and monitors progress.
• Attends facilitations/mediations as assigned.
• Manages diary system to move losses to conclusion in a timely manner.
• Collaborate closely with internal teams, including risk management, underwriting, and claims leadership to support effective claim outcomes.
• Other duties as assigned by the Claims Manager.

Required Qualifications:

• Bachelor’s Degree; minimum of two years of claims experience handling multi-line claims or an equivalent combination of education and experience.
• Must have knowledge of coverage, liability, and complex claims handling procedures.
• Ability to handle complex case-related tasks in a fast-paced and changing environment.
• Excellent interpersonal skills and the ability to work in a strong team environment.
• Excellent verbal and written communication skills, with the ability to deliver clear, professional, and customer-focused communication.
• Must have strong organizational and time-management skills, including the ability to prioritize, multitask, meet deadlines, and independently follow up on open items.
• Must be dependable, reliable, and able to achieve high levels of professionalism when handling cases and interacting with school district representatives and their employees, attorneys, families of injured and fellow employees.
• Must be able to create and maintain high levels of confidentiality when dealing with proprietary information and sensitive situations.
• Must have strong cognitive and analytical skills.
• Ability to travel and work remotely on a periodic basis.
• Proficiency in Microsoft Office applications, including Excel and Word, with the ability to use technology effectively to document, track and communicate claim activity.
• Commitment to continuous learning including willingness to participate in ongoing education with industry recognized training (IIA, AIC or INS or other relevant claims designations)

Physical Demands / Work Environment

Several hours per day at a sit/stand desk, average mobility to move around an office environment; able to spend several hours per day at a computer. Occasional in-state travel may be required. Punctual, regular, and consistent attendance is required.

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace.