Florida PIP Claims Adjuster

7 days ago


Miami, Florida, United States Embark MGA Full time
Job Opportunity

We are seeking a highly skilled and experienced Medical Adjuster to join our team at Embark MGA. As a Medical Adjuster, you will be responsible for handling Florida PIP claims, including investigations and demand handling.

Key Responsibilities
  • Handle Florida PIP claims, including investigations and demand handling.
  • Prior experience in handling Florida PIP, Medical Payments and First Party Benefits, including medical knowledge and technical compliance requirements.
  • Make appropriate coverage decisions by applying statute and case law.
  • Submit files for Peer Review when necessary.
  • Review bills received for compliance, peer reviews, etc.
  • Work in tandem with the SIU Department and Department of Insurance Fraud Division.
  • Handle cases involving attorney representation.
  • Excellent organizational and workflow skills.
  • A personal drive for excellence and proven track record of excellence.
  • Excellent communication skills both oral and written.
  • Proven ability to interact with team, peers and management to create a positive environment and achieve common goals.
  • Refer cases to the Subrogation Department for recovery when applicable.
Requirements
  • High School Diploma.
  • Minimum 2 years of Florida PIP handling experience required.
  • Valid Florida Adjuster license required.
  • Must be proficient in Microsoft Office.
  • Excellent interpersonal and verbal/written communication skills.
  • Ability to make effective decisions on behalf of the organization.


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