Senior Personal Injury Protection Adjuster

FCIC•Chicago, IL

About The Position

As a Senior Personal Injury Protection (PIP) Specialist, you will evaluate and manage claims filed under PIP coverage for commercial and personal insurance policies. You will investigate claims, assess injuries, negotiate settlements, and ensure compliance with relevant laws and regulations. The position also includes analyzing newly filed suits and overseeing litigation in collaboration with legal counsel. First Chicago Insurance Company offers a competitive benefits package to full-time employees. The estimated compensation range is $54,750–$97,500 per year; published ranges are estimates.

Requirements

Bachelor's degree or equivalent work experience.
Previous experience in auto claim adjusting, preferably focused on 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 the ability to assess complex situations and make informed decisions.
Effective negotiation skills and the ability to resolve conflicts and disputes.
Exceptional verbal and written communication skills, with the ability to convey information clearly and concisely.
Detail-oriented, with strong organizational and time-management skills.
Proficiency in relevant claims-management and documentation software applications.

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 reported injuries using medical documentation, diagnostic tests, and expert opinions.
Determine PIP coverage applicability based on policy terms, state regulations, and claim specifics.
Negotiate fair and equitable 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.
Provide customer service to claimants by responding to inquiries and offering assistance throughout the claims process.
Manage pre-authorization requests and identify cases requiring an IME.
Stay current on industry trends, legal developments, and medical advancements relevant to PIP claims.
Analyze claims involving newly received suits, including coverage, liability, and damages.
Manage and oversee litigation processes in collaboration with legal counsel to develop case-resolution strategies.