Claims Specialist II, First Party Medical

Branch Financial, LLC•Columbus, OH

5d•$59,500 - $85,000•Remote

About The Position

As a Senior Claims Specialist, First Party Medical at Branch, you’ll be assisting Branch members in their time of greatest need. When an auto claim is reported, you’ll be the face and voice of Branch to our members, ensuring they feel comfortable and have clear expectations about the claims process. We’re building a technology-first and data-driven claims experience to enhance client experience while eliminating traditional claims inefficiencies. We are in need of an experienced claims professional to investigate and resolve auto PIP & MedPay claims of varying complexity. The ideal candidate will be a member-focused “do-er”. You should not be afraid to roll their sleeves up to ensure we’re achieving industry best outcomes all while making sure we’re delivering on our promise to the Branch members.

Requirements

3+ years of progressive front line multi-state PIP & MedPay claims handling experience
Willing to go above and beyond to deliver an industry-leading member experience
Strong interpersonal skills
Ability to communicate at all levels of the organization
Creative, out of the box thinker who has a passion for helping others
Ability to “Call the Play” with imperfect information

Nice To Haves

1+ years of experience with resolving litigated claims including directing outside panel counsel is preferred
Adjuster license(s) and experience handling claims in multiple states is strongly preferred (MI, NY, NJ, FL)
Knowledge of venue specific No-Fault laws and Regulations including MCCA
Experience with bill adjudication
Experience working remotely is preferred

Responsibilities

Investigate and resolve non-litigated and litigated First Party PIP & MedPay claims within the claims department
Process non-medical benefits such as loss wages, funeral or other benefits
Contact insureds, attorneys, medical providers and other relevant parts to appropriately complete necessary investigations
Proactively keep all relevant parties apprised of claim status
Work within the claims system and with preferred partners to ensure quality documentation
Evaluate the need for medical management when appropriate
Process submitted bills in accordance with statutory requirements
Demonstrated excellent interpersonal written and verbal communication skills
Identify potential fraud indicators and work closely with siu when appropriate
Ability to work non-traditional work hours
Resolve all claims in accordance with state and company guidelines
May perform other responsibilities as assigned