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PIP Claims Specialist
2 months ago
As a Personal Injury Protection ("PIP") Claims Specialist at First Chicago Insurance Company (FCIC), you will play a crucial role in the evaluation and management of claims associated with Personal Injury Protection coverage. Your responsibilities will include investigating claims, assessing injuries, negotiating settlements, and ensuring adherence to applicable laws and regulations.
Core Responsibilities
- Analyze and evaluate PIP claims to ascertain coverage, liability, and injury severity.
- Conduct comprehensive investigations into each claim's circumstances, including gathering medical records, police reports, and witness statements.
- Assess the nature and extent of injuries reported by claimants through medical documentation and expert evaluations.
- Determine the applicability of PIP coverage based on policy details, state regulations, and claim specifics.
- Negotiate fair settlements with claimants, legal representatives, and healthcare providers to resolve claims efficiently.
- Maintain meticulous records of claim files, including all correspondence, investigation outcomes, settlement proposals, and payment transactions.
- Communicate effectively with claimants, legal representatives, medical providers, and other stakeholders to provide updates and address inquiries.
- Ensure compliance with all relevant laws, regulations, and company policies throughout the claims process.
- Deliver exceptional customer service to claimants by addressing their inquiries and providing assistance throughout the claims journey.
- Stay informed about industry trends, legal changes, and medical advancements related to PIP claims to enhance your expertise and effectiveness.
Qualifications
- Bachelor's degree or equivalent professional experience.
- Prior experience in claims adjusting, particularly with a focus on PIP claims.
- Strong understanding of insurance principles, coverage types, and regulations governing PIP.
- Excellent analytical skills to assess complex situations and make informed decisions.
- Effective negotiation skills to resolve conflicts and disputes amicably.
- Outstanding communication skills, both verbal and written, with the ability to convey information clearly.
- Detail-oriented with strong organizational and time management abilities.
- Proficiency in relevant software applications for claims management and documentation.
- Experience with non-standard insurance claims is preferred.
- PA P&C/All Lines License is preferred.
Benefits
- Competitive Salaries
- Commitment to Training & Development
- Medical and Dental Coverage
- Telemedicine Benefits
- 401k with a generous company match
- Paid Time Off and Holidays
- Tuition Reimbursement Programs
- Wellness Initiatives
- Company-sponsored events
- And much more
