Claims Representative, PIP IA

Job description

In this fast-paced role, PIP Claims Representatives adjust first party personal injury claims according to state compliance requirements and guidelines. RESPONSIBILITIES: - This position will handle Personal Injury Protection claims in multiple states, including NJ and PA - The PIP Claim Representative will receive between 3 to 5 first reports a day with a priority on patient contact, service, and claim disposition. - Daily duties include first claim reports, Image Right tasks, medical bill review, treatment monitoring, reserve assessment and Nursing interaction. - Maintains an effective follow-up system on pending files, prioritizes and handles multiple tasks simultaneously, adjusting to fluctuating workload, and advises injured parties as to the status of their claim. - Investigates and interprets policy provisions and conditions to make a coverage determination. - Functional knowledge of medical terminology and anatomy with a thorough understanding of Personal Injury Protection claim handling regulatory requirements is preferred but not necessary. - The PIP Claim Representative must have the ability to multitask in time sensitive situations. - Ensures that service, loss, and exp...