This position will handle Personal Injury Protection claims in multiple states. The PIP Claim Representative will receive between 2 to 3 first reports a day with a priority on patient contact, service, and claim disposition. Daily duties include first reports, mail tasks, medical bill review, treatment monitoring, and reserve assessment. Thoroughly screen all injured parties, investigate new losses in compliance with defined procedures and establish appropriate claims. Conduct thorough and promp... more details
Senior Claims Representative, Personal Injury Protection
Job LocationsUS-NY-Uniondale
ID
2024-5341
Category
Claims
Type
Regular Full-Time
In this fast-paced role, the Senior PIP Representatives adjusts first party personal injury claims according to state compliance requirements and guidelines.
Essential Functions and Responsibilities
This position will handle Personal Injury Protection claims in multiple states.
The PIP Claim Representative will receive between 2 to 3 first reports a day with a priority on patient contact, service, and claim disposition.
Daily duties include first reports, mail tasks, medical bill review, treatment monitoring, and reserve assessment.
Thoroughly screen all injured parties, investigate new losses in compliance with defined procedures and establish appropriate claims.
Conduct thorough and prompt investigations of accidents recognizing SIU and Subrogation potential.
Maintains an effective follow-up system on pending files, prioritize and handle multiple tasks simultaneously, adjust to fluctuating workload, advises injured parties as to the status of the claim. Assure that voice mail is properly utilized and telephone messages are promptly returned.
Investigates and interprets policy provisions and conditions to make a coverage determination.
Functional knowledge of medical terminology and anatomy with a thorough understanding of Personal Injury Protection claim handling regulatory requirements is preferred.
The PIP Claim Representative must have the ability to multitask in time sensitive situations.
Ensures that service, loss and expense control are maintained at all times.
Adheres to privacy guidelines, law and regulations pertaining to claims handling.
Candidates must have strong customer service, organization, verbal and written skills and have the ability to work in a small team environment.
Qualifications and Education
5+ years of PIP claims handling experience.
A Bachelor’s degree from an accredited four-year college or university is a plus.
Strong telephone customer service skills and the ability to empathize is needed.
Basic personal computer skills including working knowledge of Microsoft Office Suite products.
About the Company
The Plymouth Rock Company and its affiliated group of companies write and manage over $1.6 billion in personal and commercial auto and homeowner’s insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 2,000 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
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