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Auto Claims Adjuster

2 months ago


Trenton, New Jersey, United States PeopleShare Full time
Job Summary

We are seeking a highly skilled and detail-oriented Auto Claims Representative to join our team at PeopleShare. As a key member of our insurance team, you will be responsible for handling auto claims, verifying coverage, and determining the course of action.

Key Responsibilities
  • Receive and process assigned claims, verifying coverage and confirming eligibility.
  • Conduct thorough investigations through telephone and written correspondence with subscribers, attorneys, witnesses, and other relevant parties.
  • Analyze information obtained during investigations to evaluate claims, determine PIP eligibility, and assess the extent of injuries and claim exposure.
  • Establish and maintain proper reserves for exposure.
  • Assign medical case managers or experts to cases when necessary and arrange for independent medical examinations to determine medical necessity and causal relationship of treatment.
  • Handle incoming calls and correspondence from subscribers, claimants, attorneys, and providers regarding questions or problems associated with a claims.
  • Document claim files and maintain a diary system for reporting and claim follow-up.
  • Work closely with the Special Investigation Unit, Underwriting Department, attorneys, and other members of the Claim Department.
  • Manage allocated loss adjustment expense and direct the activities of vendors to ensure only necessary work is completed.
  • Comply with all conditions outlined in the Unfair Claim Practices Acts.
Requirements
  • Bachelor's degree or commensurate experience in the insurance industry.
  • A minimum of 2 years PIP claim handling experience or commensurate medical experience. Litigation experience is a plus.
  • Licenses/Designations: Property and Casualty license a plus.
  • Specific Skills: Ability to analyze coverages, liability, and damages. Strong technical knowledge of statutes and regulations governing personal injury protection claims. Working practical knowledge of litigation from assignment to discovery and trial.
  • Other Required or Preferred Qualifications: Detail-oriented with strong written and verbal communication skills. Ability to work independently and possess strong interpersonal skills necessary to contribute as a team player.