PIP Claims Representative- Gainesville, FL

Florida Farm Bureau Insurance•Gainesville, FL

2d•Onsite

About The Position

This position is responsible for managing and adjusting medical insurance claims under Personal Injury Protection and/or Medical Payments coverage. In this role, you will ensure timely and accurate processing of claims while maintaining compliance with regulatory requirements and company standards. The PIP Claims Rep ensures timely and accurate processing of claims while maintaining compliance with regulatory requirements and company standards.

Requirements

H.S. Diploma is required
Must obtain Adjuster's license in 6 months
Customer service experience
Familiarity with medical terminology & treatment protocols
Proficient in English written and Verbal communication skills
Possesses strong technical aptitude
Proficient PC skills
Good math skills
Ability to type approximately 50wpm

Responsibilities

Review, investigate, and process PIP and/or Medpay claims in accordance with applicable laws and policy provisions.
Determine coverage eligibility, verify medical necessity, and assess reasonableness of charges.
Communicate with claimants, medical providers, attorneys, etc. to gather necessary documentation to resolve claims.
Maintain detailed and accurate claim files and documentation.
Provide clear and empathetic communication to claimants and stakeholders.
Address inquiries and resolve issues promptly and professionally.
Prepare reports and summaries for management as needed.
Regular and predictable attendance is required.