PIP Claims Assistant

NJM Insurance Group•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. Required Qualifications: Knowledge, skills & abilities, experience, minimum & desired education, certification and/or license 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 Preferred Qualifications A college degree or three years of claims experience Compensation: Salary is commensurate with experience and credentials. Pay Range: $46,950-$54,546 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. Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business. What Makes NJM Different? The NJM team comprises talented people who do the right thing by our policyholders and each other. You’ll be part of a financially strong and stable company that has flourished on relationships, integrity, and service for more than a century. NJM is a special place where you can propel your career, help others, and make friends—all at the same time. NJM is proud to offer our employees continuous learning options, outstanding benefits, access to wellness programs, and opportunities to give back to the communities we are privileged to serve. We have been named a Forbes America’s Best-in-State Employer for five consecutive years. Come join us! It’s time for you to make a difference on our remarkable team.

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.

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