PIP Claims Assistant

New Jersey Manufacturers • Trenton, NJ

1d • Hybrid

About The Position

The MCS department is searching for a PIP Claims Assistant . The PIP Claims Assistant reports directly to the PIP Administrator/Supervisor, the PIP Claims Assistant supports the PIP Department by performing assigned claim functions and tasks. The position requires the assistant to work and communicate with the PIP Claims Representatives, PIP Supervisors, and other team members. The position also interacts with NJM policyholders, associated injured parties or their legal representatives, medical providers, and other departments within NJM, as needed. Hours Monday-Friday, specific hours are subject to selected start time between 8am-9am pending supervisory approval. Hybrid opportunity after training is completed (3 days in office, 2 days remote) Essential Duties and Responsibilities: Essential functions of this job are listed below in order of priority. Reasonable accommodations may be made to enable individuals to perform the essential duties. Regular and predictable onsite attendance is an essential function of the job. Initiate contact with insureds, claimants, or their representatives to obtain pertinent information and to clearly explain the policy, coverage, and claims process. Document and process No-Fault benefit claims consistent with statutory and NJM guidelines. Complete independent evaluation/determination of claim coverage and provide recommendation to supervisor. Provide claim information to insured and medical providers and respond to inquiries as needed. Issue expense payments as outlined in the authority limit profile, retrieve, and distribute PIP Payment ledgers, manage incoming calls, and direct calls to appropriate individuals or departments, if unable to answer. Respond to incoming correspondence and prepare claim files and/or other communication for distribution to external customers. Manage various queues within ClaimCenter. Participate in special projects or initiatives. Participate in User Acceptance Testing to ensure appropriate system functionality after program upgrades. Participate in educational or training activities as required. Perform other duties as requested.

Requirements

• Knowledge of Word and Excel
• Strong PC skills, including accurate data entry and typing ability.
• Effective communication skills
• Customer service experience
• Ability to work independently and in a team environment.
• Ability to multi-task, prioritize work activities, and use time efficiently.
• Detail-oriented.
• Demonstrate accuracy and thoroughness.
• Demonstrate reliability and conform to the company’s attendance policy.
• High School Diploma or GED Equivalent

Nice To Haves

• A college degree or three years of claims experience

Responsibilities

• Initiate contact with insureds, claimants, or their representatives to obtain pertinent information and to clearly explain the policy, coverage, and claims process.
• Document and process No-Fault benefit claims consistent with statutory and NJM guidelines.
• Complete independent evaluation/determination of claim coverage and provide recommendation to supervisor.
• Provide claim information to insured and medical providers and respond to inquiries as needed.
• Issue expense payments as outlined in the authority limit profile, retrieve, and distribute PIP Payment ledgers, manage incoming calls, and direct calls to appropriate individuals or departments, if unable to answer.
• Respond to incoming correspondence and prepare claim files and/or other communication for distribution to external customers.
• Manage various queues within ClaimCenter.
• Participate in special projects or initiatives.
• Participate in User Acceptance Testing to ensure appropriate system functionality after program upgrades.
• Participate in educational or training activities as required.
• Perform other duties as requested.

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
• Number of Employees: 501-1,000 employees