Senior Personal Injury Protection Adjuster

First Chicago Insurance Company (FCIC)•Chicago, IL

8d•$54,750 - $97,500

About The Position

As a Senior Personal Injury Protection (PIP) Specialist, you will evaluate and manage claims filed under PIP coverage of commercial and personal insurance policies. The role involves investigating claims, assessing injuries, negotiating settlements, and ensuring compliance with applicable laws and regulations. You will also analyze newly litigated claims and oversee litigation in coordination with legal counsel.

Requirements

Bachelor’s degree or equivalent work experience.
Previous experience in auto claim adjusting, preferably involving commercial PIP claims in New Jersey and Pennsylvania.
Previous experience with AICRA in New Jersey and MVFRL in Pennsylvania.
Strong knowledge of insurance principles, coverage types, and regulations governing PIP.
Strong analytical skills and ability to assess complex situations and make informed decisions.
Effective negotiation skills and ability to resolve conflicts and disputes.
Strong verbal and written communication skills, with the ability to convey information clearly and concisely.
Detail orientation and strong organizational and time-management skills.
Proficiency in relevant claims management and documentation software.

Nice To Haves

Previous litigation experience is preferred but not required.
Prior Non-Standard Auto Claims experience is a plus but not required.

Responsibilities

Review and assess PIP claims to determine coverage, liability, and the extent of injuries.
Investigate claim circumstances, including obtaining medical records, police reports, and statements.
Evaluate the nature and severity of first-party claimants’ injuries using medical documentation, diagnostic tests, and expert opinions.
Determine PIP coverage applicability based on policy terms, state regulations, and claim specifics.
Negotiate settlements with claimants, attorneys, and medical providers.
Maintain detailed and accurate claim records, including correspondence, investigation findings, settlement offers, and payment transactions.
Communicate with claimants, legal representatives, medical providers, and other stakeholders to provide updates, address concerns, and facilitate the claims process.
Ensure compliance with applicable laws, regulations, and company policies throughout claims handling.
Address first-party claimants’ inquiries promptly and assist them throughout the claims process.
Manage pre-authorization requests and identify cases requiring an independent medical examination (IME).
Stay current on industry trends, legal developments, and medical advancements relevant to PIP claims.
Analyze claims upon receipt of a new suit, including coverage, liability, and damages.
Manage litigation processes and work with legal counsel to develop case-resolution strategies.