PIP Claims Adjuster

Corporate Claims Service, Inc. is a third party administrator who specializes in the transportation industry. Our mission is Excellence in Service. We were founded in 1998 by an exceptional team of insurance industry veterans. We have the reputation for quality work, colleague friendly environment and progressive employment practices. Come be a part of our team and “Claim your Future”.

Summary

We are seeking a highly motivated and ambitious PIP Claims Adjuster to aggressively investigate, evaluate, reserve, negotiate and settle assigned multi-line rental, business auto and trucking claims in accordance with Best Practices. Provide quality claim handling and superior customer service on assigned claims while engaging in indemnity and expense management. This is a full-time position.

We offer a competitive salary along with medical, dental and vision insurance, 401K, paid vacation and a flexible work schedule.

Duties and Responsibilities

Review PIP coverages and/or identify coverage issues and investigate and analyze the loss event, the injury and other relevant information to make a determination as to coverage and course of action.
Evaluate claims for fraud indicators and potential underwriting issues and process appropriate referrals. Conduct activities in compliance with state and company regulations and guidelines.
Render final coverage determination within regulatory guidelines: Maintain communication with involved parties during the course of the claim, via written and/or verbal communication, to provide relevant determinations and/or information.
Maintain communication with involved parties during the course of the claim, via written and/or verbal communication, to provide relevant determinations and/or information. Concisely and accurately document all actions taken throughout the course of the claim.
Manage all requests for medical treatment, durable medical equipment, medical guidelines and policies, internal and/or external peer reviews and/or IMEs, when required, communicate determinations to appropriate parties within 3 business days.
Request necessary Independent Medical Examinations and render determinations for additional treatment or termination benefits.
Establish adequate medical and non-medical benefits reserves for the life of the claim and adjust reserves, if needed.
Calculate and issue non-medical benefits (wages, essential services, death benefits).
Understands and applies all process and regulatory knowledge associated with arbitration and subrogation. Effectively utilizes all applications and manages time and responsibilities

Requirements

College degree or equivalent industry experience preferred
1+ years of PIP claims handling experience
Experience handling litigated files required
Knowledge of multiple jurisdictions
Professional designations a plus
State licenses preferred as they will be required
State license must be obtained as required
Strong negotiation and customer service skills
Strong organizational and time management skills
Strong, effective communication skills
Customer focus
Computer proficiency, with knowledge of Microsoft Office
Decision making

If you are a self-motivated, results-oriented professional who thrives in a fast-paced environment, please send a cover letter and resume to our Human Resources department.

Corporate Claims Service is an Equal Opportunity Employer.

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