Associate PIP Claims Rep (Remote)

Selective Insurance Company of America•UNAVAILABLE, UNAVAILABLE

8d•Remote

About The Position

Selective Insurance is seeking an Associate PIP Claim Representative for this remote position. Investigates, negotiates, and concludes by settlement or denial assigned Personal Injury Protection and Medical Payment claims, including claims from multiple states with different laws and regulations, and medical cost containment requirements, through telephone, personal contact or written correspondence, up to $50,000.00. These duties are performed consistent with company claim’s policies and procedures, prescribed authority, and standards of performance. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements.

Requirements

Knowledge of PIP law, regulations, and medical cost containment requirements from multiple states.
Working knowledge of medical terminology.
Must have a valid state-issued driver’s license in good standing and be able to drive an automobile
College degree preferred
Minimum of one year claims experience and 1 year data entry experience

Responsibilities

Receive assigned claims, verify coverage and determine course of action on claims up to $50,000.
Process claims which includes following the activities: set up file in 365, establish initial reserves, conduct claim investigation, analyze investigational data, use effective cost containment strategies, settle non-litigated claims, process expenses/loss incurred, prepare check requisitions, explore subrogation potential, and close claims.
Document claim files and maintain control of work through documentation or diary system.
Send checks, letters of denial and complete reporting forms for file assigned and assist the department with payments, letters and phone calls when needed.
Assign medical or other experts to case and arrange for medical examinations when necessary.
Ensure compliance with company, state, and federal regulations.
Must be able to drive an automobile. Car travel represents approximately 10% of employee’s time and a valid drivers license.