PIP Claims Resolution Expert

1 week ago

Atlanta, Georgia, United States Reserv Full time
Job Overview

Position Summary

About Reserv

Reserv is an innovative insurtech firm dedicated to developing advanced AI and automation solutions to enhance efficiency and simplicity in claims management. Established by industry veterans with extensive experience in SaaS and digital claims, Reserv is supported by prominent investors and aims to revolutionize the claims process by addressing long-standing challenges faced by TPAs, insurance technology providers, and adjusters.

We are on the lookout for a meticulous Personal Injury Protection Resolution Specialist who thrives in a dynamic environment. If you are passionate about redefining the claims landscape and are eager to tackle the complexities of the role, we would be excited to connect with you.

Role Responsibilities

The PIP Resolution Specialist will play a crucial role in:

  • Conducting thorough investigations and evaluations of PIP/MP claims and coverage.
  • Providing exceptional customer service to all stakeholders involved in the claims process.
  • Managing a portfolio of PIP claims and ensuring timely resolution.
  • Collaborating with product and engineering teams to suggest enhancements in technology and processes.

Key Attributes

  • Driven and eager to contribute to a tech-focused claims organization.
  • Customer-centric mindset with a focus on enhancing the claimant experience.
  • Empathetic and patient in all interactions.
  • Possessing a strong sense of urgency without compromising work-life balance.
  • Creative problem-solver who seeks optimal outcomes for claimants.
  • Enjoys constructive dialogue in conflict situations.
  • Inquisitive and committed to understanding the complete context of claims.
  • Proactive in implementing changes to improve processes.
  • Excellent communicator with a sense of humor.

Essential Duties

The responsibilities of the role include:

  • Delivering prompt and courteous service to policyholders and claimants.
  • Assessing PIP/MP claims for coverage and evaluating medical billing for relevance and necessity.
  • Collecting necessary documentation and engaging with involved parties to clarify policy and coverage.
  • Evaluating the legitimacy of PIP claims based on evidence and applicable regulations.
  • Managing claim inventories and adjusting reserves as needed.
  • Ensuring adherence to state regulations and company policies.
  • Maintaining regular communication with all parties to keep them informed on claim status.
  • Preparing comprehensive claim reports that detail investigation findings and decisions.
  • Contributing to the ongoing development of claims guidelines and best practices.
  • Coordinating with external investigative services to facilitate claim resolution.
  • Engaging in professional development opportunities to enhance knowledge of claims processes.

Qualifications

  • Bachelor's degree preferred, but not mandatory if other qualifications are met.
  • A minimum of 3 years of focused experience in Personal Injury Protection.
  • Familiarity with regulations in states such as NY, NJ, MI, FL, or KY.
  • Experience with subrogation referrals and bodily injury coordination.
  • Knowledge of arbitration and PIP/MP litigation processes.
  • Active adjuster license(s) with a willingness to obtain additional licenses as required.
  • Strong analytical skills and the ability to make informed decisions.
  • A genuine interest in problem-solving and challenging the status quo.
  • Willingness to travel as necessary for claims-related activities.

Benefits

  • Comprehensive health insurance with nationwide coverage.
  • 401(k) plan with employer matching contributions.
  • Generous paid time off policy to promote employee well-being.
  • Family leave policy that supports work-life balance.
  • Flexible work arrangements with opportunities for team retreats.
  • Provision of high-quality technology to enhance productivity.

Commitment to Diversity

At Reserv, we celebrate diversity and believe that varied perspectives drive innovation and success. We are committed to creating an inclusive environment and welcome candidates from all backgrounds to apply.

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