Bristol West Claims Medpip Rep

Farmers Insurance Careers•East Grand Rapids, MI

6d•$54,100 - $77,854•Hybrid

About The Position

A Bristol West Med Pay/PIP (Personal Injury Protection) representative conducts claims investigations, coverage confirmation, establishes appropriate medical necessity and payment of claims settlement. Using claims systems to accurately document files, they manage a diary and handle first party medical claims promptly, proactively and with a sense of urgency.

Requirements

High school diploma or equivalent required. Bachelor’s degree preferred.
Less than one year of Insurance industry or related experience preferred.
Proven problem solving skills
Ability to work in a fast paced environment
Solid decision making skills

Responsibilities

Evaluates Personal Injury Protection (PIP) and Med Pay claims for eligibility, medical necessity, and appropriateness of charges in accordance with state fee schedules.
Determines relatedness, causation, and appropriateness of treatment based on the compensable injury.
Provides reserve recommendations and makes payment approval to ensure activities are consistent with corporate policies.
Conducts detail bill reviews and process claims within designated authority levels.
Makes contacts with stakeholders to investigate and process claims.
Contacts may include multiple attempts to communicate with various parties and requires telephone conversations or other methods of communication to be a priority.
Parties involved could include policy holders, claimants, agents, witnesses, contractors, police and fire departments, state and county fraud and arson personnel, special investigators, attorneys, expert witnesses, members of the medical profession and other persons pertaining to the investigation and processing of claims.
Performs other duties as assigned.

Benefits

Farmers offers a competitive salary commensurate with experience, qualifications and location.
Bonus Opportunity (based on Company and Individual Performance)
401(k)
Medical
Dental
Vision
Health Savings and Flexible Spending Accounts
Life Insurance
Paid Time Off
Paid Parental Leave
Tuition Assistance