Claims Representative I, PIP

Plymouth Rock Assurance • Woodbridge Township, NJ

1d • $57,000 - $76,000 • Onsite

About The Position

In this fast-paced role, the PIP Representative adjusts first party personal injury claims according to state compliance requirements and guidelines. This position will handle Personal Injury Protection and Extended Medical Expense Benefit claims in multiple states. The PIP Claim Representative will receive between 3 to 5 first reports a day with a priority on service, patient contact, and claim disposition. Daily duties include first reports, Image Right tasks, medical bill review, treatment monitoring, reserve assessment and Nursing interaction. Maintains an effective follow-up system on pending files, prioritize and handle multiple tasks simultaneously, adjust to fluctuating workload, advises injured parties as to the status of the claim. Investigates and interprets policy provisions and conditions to make a coverage determination. The PIP Claim Representative must have the ability to multitask in time sensitive situations. Ensures that service, loss and expense control are maintained at all times. Adheres to privacy guidelines, law and regulations pertaining to claims handling. Candidates must have strong customer service, organization, verbal and written skills and have the ability to work in a small team environment.

Requirements

• A Bachelor’s Degree (B.A.) from a four-year college or university.
• One (1) to three (3) years related claims experience and/or training.
• Basic personal computer skills including working knowledge of Microsoft Office Suite products.
• Strong customer service, organization, verbal and written skills.
• Ability to work in a small team environment.

Nice To Haves

• Functional knowledge of medical terminology and anatomy with a thorough understanding of Personal Injury Protection claim handling regulatory requirements.

Responsibilities

• Handle Personal Injury Protection and Extended Medical Expense Benefit claims in multiple states.
• Receive between 3 to 5 first reports a day with a priority on service, patient contact, and claim disposition.
• Perform daily duties including first reports, Image Right tasks, medical bill review, treatment monitoring, reserve assessment and Nursing interaction.
• Maintain an effective follow-up system on pending files, prioritize and handle multiple tasks simultaneously, adjust to fluctuating workload, and advise injured parties as to the status of the claim.
• Investigate and interpret policy provisions and conditions to make a coverage determination.
• Multitask in time sensitive situations.
• Ensure that service, loss and expense control are maintained at all times.
• Adhere to privacy guidelines, law and regulations pertaining to claims handling.

Benefits

• 4 weeks accrued paid time off + 9 paid national holidays per year
• Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
• Annual 401(k) Employer Contribution
• Free onsite gym and health center at our Woodbridge location
• Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
• Robust health and wellness program and fitness reimbursements
• Various Paid Family leave options including Paid Parental Leave
• Tuition Reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level