PIP Claims Specialist
2 weeks ago
As a Personal Injury Protection ("PIP") Claims Specialist, your primary role will involve the assessment and management of claims submitted under the Personal Injury Protection coverage of insurance policies. You will be tasked with investigating claims, evaluating injuries, negotiating settlements, and ensuring adherence to applicable laws and regulations.
Key Responsibilities
- Analyze and evaluate PIP claims to ascertain coverage, liability, and the severity of injuries.
- Conduct comprehensive investigations into the details surrounding each claim, including gathering medical records, police reports, and witness statements.
- Assess the nature and extent of injuries reported by claimants through medical documentation, diagnostic evaluations, and expert insights.
- Determine the applicability of PIP coverage based on policy stipulations, state laws, and the specifics of each case.
- Engage in negotiations to achieve fair and reasonable settlements with claimants, legal representatives, and healthcare providers.
- Maintain meticulous and accurate records of claim files, encompassing correspondence, investigation results, settlement proposals, and payment transactions.
- Communicate effectively with claimants, legal representatives, medical professionals, and other stakeholders to provide updates, address inquiries, and facilitate the claims process.
- Ensure compliance with all relevant laws, regulations, and organizational policies throughout the claims handling process.
- Deliver exceptional customer service to claimants by promptly addressing inquiries and providing assistance throughout the claims journey.
- Stay informed about industry trends, legal changes, and medical advancements pertinent to PIP claims to enhance your expertise and effectiveness in the role.
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 abilities to evaluate complex situations and make informed decisions.
- Effective negotiation skills to resolve conflicts and disputes.
- Outstanding communication skills, both verbal and written, with the ability to convey information clearly and concisely.
- Detail-oriented with strong organizational and time management capabilities.
- 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.
First Chicago Insurance Company offers a competitive benefits package to all full-time employees, including:
- Competitive Salaries
- Commitment to Training & Development
- Medical and Dental Coverage
- Telemedicine Benefits
- 401k with a generous company match
- Paid Time Off and Paid Holidays
- Tuition Reimbursement Programs
- Wellness Initiatives
- Company-sponsored events
- And much more
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