Commercial Auto Claims Rep - PIP (Temp to hire)

The Jonus Group•Omaha, NE

9d•Remote

About The Position

Seeking a highly skilled and experienced Commercial Auto Claims Representative specializing in Personal Injury Protection (PIP) to join a team on a temporary-to-hire basis. This fully remote role involves handling commercial auto first-party medical benefit claims, especially PIP and Medical Payments (MedPay), with multi-state experience considered a significant advantage. The position pays $37–$41 per hour. A bachelor’s degree is required, though equivalent relevant claims experience may be considered. The successful candidate must hold a home state adjuster license and be able to obtain Texas and Florida licenses; the company covers the licensing costs. The role may require travel for company or claim-related events.

Requirements

At least 3 years of auto claims experience, including hands-on PIP and/or MedPay claim handling.
Strong understanding of no-fault/PIP and MedPay coverage, medical terminology, medical billing, benefit limits, fee schedules, and state-specific claim deadlines.
Ability to interpret insurance policy language and evaluate medical documentation.
Excellent written and verbal communication skills, including professional correspondence with providers and attorneys.
Strong organizational, analytical, and time-management skills.
Proficiency in computer systems and ability to adapt quickly to new claim systems and procedures.
Bachelor’s degree required; equivalent relevant claims experience may be considered.
Must have a home state adjuster license and the ability to obtain Texas and Florida licenses.
Ability to travel for company or claim-related events if needed.

Nice To Haves

Multi-state PIP experience.
Insurance industry designations.
Familiarity with salvage platforms and total loss claims.
Cargo claims experience.

Responsibilities

Investigate and manage assigned commercial auto first-party medical benefit claims.
Verify applicable coverage, eligibility, benefits, limits, deductibles, exclusions, and coordination-of-benefits requirements.
Review policy language and apply state-specific PIP, no-fault, and MedPay statutes, regulations, and fee schedules.
Evaluate accident information, medical records, itemized bills, treatment notes, and wage documentation to determine benefit eligibility and payment.
Review medical bills for coding accuracy, duplication, relatedness, reasonableness, and necessity.
Process covered medical expenses, wage-loss benefits, and other PIP benefits in compliance with policy terms and applicable laws.
Maintain accurate benefit payment ledgers and monitor remaining limits, deductibles, and offsets.
Communicate professionally with insureds, claimants, medical providers, attorneys, and internal partners about claim status and benefit determinations.
Recognize and escalate disputed treatments, suspected fraud, coverage concerns, and other issues requiring legal or supervisory review.
Prepare timely and accurate correspondence, including requests for information, explanations of benefits, and coverage decisions.
Manage an active claim inventory efficiently while meeting quality, timeliness, and customer-service expectations.
Coordinate with bodily injury, liability, litigation, SIU, and vendor teams as necessary.
Obtain and maintain required state adjuster licenses.