PIP Appeal and Litigation Processor

NJM Insurance Group • Trenton, NJ

1d

About The Position

Our West Trenton General Claims Legal Department is seeking a motivated, detail-oriented individual for a PIP Appeal and Litigation (PAL) Processor Processor role. Reporting to the designated supervisor and accountable for efficiently collecting and organizing pertinent information of appeal, litigation/arbitration process for adjusters and defense counsel. Essential Duties and Responsibilities: Receive, analyze, and process complaints/arbitration demands, create litigation matters, and assign to appropriate PAL adjuster for review. Assist PAL Adjusters and supervisors by accurately entering pertinent information into Claim Center, OnBase, and AgilePoint. Provide support as needed to FNOL First Notice of Loss (FNOL) Dept in taking claims. Review the investigation file material, select appropriate information, and electronically send to defense firms. Provide support to PAL Adjusters with document requests and information needed for pertinent matters. Process monthly vendor bills. Properly answer and accurately process incoming inquiries from attorneys requesting payment status, missing Bottomline entries and document requests. Periodic telephone and email communication with vendors, defense, and plaintiff counsel firms regarding litigated matters. Process incoming mail for distribution to the appropriate PAL Adjuster. Maintain Legal Exchange (electronic billing site) by creating matters for defense counsel to bill at conclusion of matter. Maintain monthly reports of arbitration demands for management review. Process all zero EOB’s within statutory timeframes for upheld payment appeals.

Requirements

• Strong verbal and written communication skills, including active listening
• Multi-tasking, problem-solving and decision-making abilities
• Ability to work independently
• Effective computer skills and ability to work in multiple systems
• Organization, time management and prioritization abilities
• Demonstrate reliability and conform to the company’s attendance policy
• Minimum High School Diploma or GED required

Responsibilities

• Receive, analyze, and process complaints/arbitration demands, create litigation matters, and assign to appropriate PAL adjuster for review.
• Assist PAL Adjusters and supervisors by accurately entering pertinent information into Claim Center, OnBase, and AgilePoint.
• Provide support as needed to FNOL First Notice of Loss (FNOL) Dept in taking claims.
• Review the investigation file material, select appropriate information, and electronically send to defense firms.
• Provide support to PAL Adjusters with document requests and information needed for pertinent matters.
• Process monthly vendor bills.
• Properly answer and accurately process incoming inquiries from attorneys requesting payment status, missing Bottomline entries and document requests.
• Periodic telephone and email communication with vendors, defense, and plaintiff counsel firms regarding litigated matters.
• Process incoming mail for distribution to the appropriate PAL Adjuster.
• Maintain Legal Exchange (electronic billing site) by creating matters for defense counsel to bill at conclusion of matter.
• Maintain monthly reports of arbitration demands for management review.
• Process all zero EOB’s within statutory timeframes for upheld payment appeals.

Benefits

• Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave.
• Employees may also be eligible for discretionary bonuses.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED