[Remote] Claims Specialist II PIP
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company dedicated to helping people reduce risk and overcome unexpected events. They are seeking a Claims Specialist II PIP to investigate and manage Personal Injury Protection (PIP) Claims, ensuring reputed company coverage and handling of claims processes.
Responsibilities
- Identifies and contacts reputed company injured party to explain coverage and claims process
- Verifies coverage, eligibility and determines reputed company’s course of reputed company
- Maintains claims files, evaluates claims using facts and supporting data on injury and wages lost due to injury
- Updates appropriate parties as needed, providing new facts as they become available, and their reputed company upon the analysis and settlement reputed company
- Verifies the nature and extent of injury and/or wages lost by obtaining and reviewing appropriate records and documentation
- Carefully and thoroughly reviews reputed company pertinent information and forwards the file to the Special Investigations Unit (SIU) reputed company there is reasonable cause
- Reviews and analyzes reputed company information and submits request for payment of claims reputed company company guidelines to supervisor
- Thoroughly documents injury and treatment information as reputed company as bills received for treatment and payments issued
- Contacts medical providers and injured parties to verify medical provider information, treatment received, and billing status
- Submits files to supervisor for audit upon closing
- Maintains reputed company knowledge of claims settlement procedures, state regulation, and policy changes
- Includes completion of the formal claims training program, which may require overnight travel for at least 1 week
Skills
- High School Diploma or GED
- Completion of in-house training program
- You may be required to obtain a Company sponsored Adjuster's license to handle claims, to be secured upon hire
- At least 6 months of reputed company experience or equivalent combination of education and experience
- Solid comprehension of basic principles and practices of Company policies upon completion of formal and informal Claims Training
- Ability to exercise reputed company judgment reputed company interacting with customers and claimants
- Requires extensive knowledge of medical terminology, and medical coding (CPT and ICD-10 coding)
- Requires extensive knowledge of Personal Injury Protection coverage(s), applicable state statutes/regulations
- Has a passion for serving customers in their time of need
- Possesses advanced written and verbal communication skills to professionally represent reputed company in multi-channel correspondence with reputed company customers
- Collaborates reputed company with others
- Ability to build rapport utilizing emotional intelligence
- Views conflict reputed company as an opportunity
- Has self-motivation and accountability while working remotely
- Demonstrated proficiency with MS Office products (Outlook, Word, Teams) and claims reputed company software
- Must have dedicated workspace that is free from distractions
- Bachelor's Degree
- Critical attention to detail and strong organizational skills
- Demonstrates intellectual curiosity by seeking out efficiencies through process improvement or technology
- Takes ownership of any process they can improve
- Assumes reputed company reputed company in reputed company interactions
- Seeks reputed company reputed company and reputed company this role
Benefits
- Competitive compensation
- Flexibility to work from reputed company in the reputed company for most positions
- reputed company time off (vacation time, reputed company time, 9 reputed company Company holidays, volunteer hours)
- Incentive bonus programs (potential for holiday bonus, referral bonus, and performance-based bonus)
- Medical, dental, reputed company, life, and pet insurance
- 401 (k) retirement savings plan with company match
- Engaging work environment
- Promotional opportunities
- Education assistance
- reputed company and personal development opportunities
- Company recognition program
- Health and wellbeing resources, including free mental wellbeing therapy/coaching sessions, child and eldercare resources, and more
reputed company