Claims PIP Manager

First Acceptance•Marianna, FL

2d•Onsite

About The Position

Directly supervises a team of PIP and/or PIP Demand Adjusters ensuring losses are handled in a professional and prompt manner and that specified goals are met. Provides direction to PIP team on all aspects of claims handling and claims supervision. Reviews and evaluates the file-handling process to meet company and statutory guidelines. Coordinates the investigation process with other units and outside vendors as required. Identifies potential for subrogation and refers claims to the subrogation group as appropriate. Identifies potential fraud and makes referrals to the special investigation unit (SIU) as appropriate. Reviews coverage based on the policy and jurisdiction. Receives, approves, or denies medical payments. Documents activity on claim files. Mentors and coaches team members to develop skills, increase job knowledge and achieve stated performance objectives. Updates the PIP Director on trends and unusual claim activity. Ensures consistent delivery of services that meets or exceeds customer expectations and complies with regulatory and company standards. Responsible for team performance management and evaluations. Performs other related duties as assigned.

Requirements

High school diploma or equivalency required.
A minimum of 5 years of experience handling Florida PIP claims including responding to pre-suit demands.
Thorough knowledge of claims investigation techniques, as well as medical and legal aspects of claims.
Knowledge of the No-Fault auto insurance policy and Florida No-Fault Statute.
A solid understanding of the claims policies and procedures in resolving pre-suit PIP demands.
Strategic-minded, and deeply committed to employee development and morale within a high-performance environment.
Ability to read, analyze, comprehend, and disseminate information from medical documents.
Ability to effectively perform in a fast-paced environment while managing multiple priorities simultaneously with a high degree of detail.
Ability to deal with dynamic situations, to be able to modify plans, actions, and decisions in light of changing situations and circumstances.
Exceptional customer service and teamwork philosophy.
Excellent verbal & written communication skills.
Above average computer skills with various industry software knowledge a plus; ability to use Microsoft Office Suite products.
Must currently hold or have the ability to secure and maintain Florida adjuster license(s) within 60 days of employment.

Nice To Haves

A 2-year degree or higher related to the insurance field is highly desirable.
Minimum of 2 years of leadership experience within the auto insurance claims industry preferred.
Medical terminology, medical coding and ICD9/10 experience preferred.

Responsibilities

Directly supervises a team of PIP and/or PIP Demand Adjusters ensuring losses are handled in a professional and prompt manner and that specified goals are met.
Provides direction to PIP team on all aspects of claims handling and claims supervision.
Reviews and evaluates the file-handling process to meet company and statutory guidelines.
Coordinates the investigation process with other units and outside vendors as required.
Identifies potential for subrogation and refers claims to the subrogation group as appropriate.
Identifies potential fraud and makes referrals to the special investigation unit (SIU) as appropriate.
Reviews coverage based on the policy and jurisdiction.
Receives, approves, or denies medical payments.
Documents activity on claim files.
Mentors and coaches team members to develop skills, increase job knowledge and achieve stated performance objectives.
Updates the PIP Director on trends and unusual claim activity.
Ensures consistent delivery of services that meets or exceeds customer expectations and complies with regulatory and company standards.
Responsible for team performance management and evaluations.
Performs other related duties as assigned.