- 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, PIP Care Paths, 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).
- Demonstrates knowledge in NJ and in other states and is able to apply regulatory requirements appropriately.
- Understands and applies all process and regulatory knowledge associated with arbitration and subrogation. Effectively utilizes all applications and manages time and responsibilities.
- Excellent verbal and written communication skills, knowledge of Microsoft suite.
- Strong interpersonal and customer service skills.
- Good organizational, time-management, and data entry skills.
- Decision-making and multi-tasking capabilities.
- Bachelor's degree preferred.
- 3-5 years of claims handling experience preferred.
-
PIP Claims Representative I
1 week ago
NJM Insurance Hammonton, United StatesNJM Insurance Group (NJM), a top-rated insurance company, is looking for a Personal Injury Protection Representative who has excellent communication skills as well as strong organizational and time management skills. We are looking for talent with and without prior experience in ...
-
PIP Claims Representative I
1 week ago
NJM Insurance Group Hammonton, United States Full timeNJM Insurance Group (NJM), a top-rated insurance company, is looking for a Personal Injury Protection Representative who has excellent communication skills as well as strong organizational and time management skills. We are looking for talent with and without prior experience in ...
-
Customer Service
1 week ago
NJM Insurance Group Hammonton, United States**Personal, compassionate service is what we're known for at NJM. We seek the best and brightest to help our customers when they need us most. As part of the NJM team, you'll not only enjoy some of the best benefits in the industry, you'll also be joining a company that's committ ...
-
CHUBB Philadelphia, United States Regular - Full timeThe ESIS Senior Claim Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established Best Practices guidelines. · This role operates on a hybrid work schedule (3 days in office, 2 days remote) and must sit ...
-
Lifelancer Philadelphia, United StatesAbout the job Patient Support Medical Biller/Claims Processing Representative · We are excited to announce that currently we are looking for a 100% remote (work from homeWFH) contact Patient Support Medical Claims Processing Representative to join our team. In this position, you ...
-
MD Field Claims Representative I, II, Sr
1 week ago
National General Insurance Cherry Hill, United StatesJob Description · This is a Hybrid role on our Auto Field Claims Team. While you will work from home, this role requires field work in the Greater Philadelphia or South Jersey area. · Job Summary: · Responsible for creating a comprehensive estimate of damages for 1st and 3rd pa ...
-
Medical Billers
3 days ago
Acentus Practice Management Mount Laurel, United States**This is not a fully remote position - you must be able to commute and report to our Mount Laurel office. Semi-remote work may be available after the successful completion of a 90 day introductory period.** · Acentus is currently seeking an Accounts Receivable (AR) Representativ ...
-
Patient Account Representative
1 week ago
Onsite Neonatal Partners, Inc Voorhees, United States**Onsite Neonatal Partners, located in Voorhees, NJ,** is a national 24/7 in-house neonatology practice that partners with leading hospitals across the country to develop and manage neonatology programs that focus on quality patient care. · **Onsite is looking for a dedicated, fu ...
-
Farmers Insurance Group Philadelphia, United States**We are Farmers** · We aremore than just your favorite commercials. At Farmers, we strive to deliver peace of mind to our customers by providing protection and comprehensive advice and delivering in the moments of truth. That means having people who can help us meet changing cus ...
-
Billing Specalist
1 week ago
Alliance Cancer Specialists Philadelphia, United StatesOverview: · **THIS IS NOT A REMOTE POSITION.** · **Top Reasons To Work for Alliance Cancer Specialists**: · Comprehensive benefits package for full-time employees including: · Medical, Dental, Vision, Life, and Disability insurance · 401k Plan · Paid Time Off · Highly competitive ...
-
Charge Entry Representative
13 hours ago
Axia Women's Health Mullica Hill, United StatesAt **Axia Women's Health,** _recognized as a Great Place to Work for the 2nd year in a row_, our vision is to lead the way in improving women's health. At the core of achieving this is a caring, connected, and progressive community of 500 providers across nearly 200 women's healt ...
-
Insurance Authorization Specialist
1 week ago
Good Shepherd Rehabilitation Network Philadelphia, United States**JOB SUMMARY** · - Acts as a liaison with all insurance providers including commercial, managed care, and governmental plans · - Gathers and submits patient information to secure prior authorizations for inpatient IRF and LTACH admissions · - Gathers and transmits required docum ...
-
Manager Fraud Claims Analytics
1 week ago
TD Bank Mount Laurel, United States**Work Location**: · Remote Mount Laurel (NJ) · **Hours**: · 40 · **Pay Details**: · $86,840 - $139,360 USD · **Line of Business**: · Financial Crimes & Fraud Mgmt · The **Manager, Fraud Claims Analytics & Strategy **is responsible for representing Fraud Performance Management in ...
-
Benefits Specialist
1 day ago
Radwell Willingboro, United States**JOB SUMMARY** · **Monday-Friday 8am-5pm** · Assist department head in developing and administering the various benefit programs including health, dental, vision, disability, life, FSA and 401K as well as paying monthly premiums. Monitors processing of employee benefit claims, c ...
-
Financial Services Representative
2 days ago
Ahida Garcia - State Farm Agent Philadelphia, United StatesAre you passionate about helping others and providing top-notch customer service? Do you thrive in a dynamic and fast-paced environment? If so, we have an exciting opportunity for you Join the Ahida Garcia State Farm Agency as a Sales Representative and become an integral part of ...
-
Customer Service Representative
2 days ago
David Samuel - State Farm Agent Philadelphia, United States**ROLE DESCRIPTION**: · As a Customer Service Representative - State Farm Agent Team Member with David Samuel Agency, you will generate the kind of exceptional client experiences that reinforce the growth of a successful insurance agency. Your attention to detail, customer servic ...
-
Physical Therapy Aide
1 week ago
Jonathan B Levyn, DO-PC Philadelphia, United States**Physical Therapy Aide (College Grads welcomed to apply)** · Are you a college grad or a Physical Therapy Aide looking for employment?....We are seeking a Physical Therapy Aide for our Family Practice located in Mayfair. As a Physical Therapy Aide you will assist with patient re ...
-
Workers Comp Adjuster
1 week ago
NJM Insurance Group Hammonton, United States**Workers Comp Adjuster** · Hammonton, NJ · **NJM Insurance Group** · ** · This isn't just insurance. It's NJM. · When you join the NJM family, you'll work with talented people who care about doing the right thing by our policyholders as well as each other. You'll be part of ...
-
Office Manager
4 days ago
CHERRY HILL TRIPLEX Cherry Hill, United States**Automotive Office Manager - Summary** · Processes and generates financial data for all dealership departments, which together represent the accurate financial condition of the business. Provides accurate reporting to the controller and is responsible for accounting office and a ...
-
Insurance Account Representative
1 week ago
Kevin Lowber - State Farm Agent Philadelphia, United States**Benefits**: · - Competitive salary · - Training & development · **ROLE DESCRIPTION**: · Kevin Lowber - State Farm Agent is searching for a competitive team member who can recognize opportunities and strategically turn leads into long-lasting customer relationships. As our Insur ...
PIP Claims Representative I - Hammonton, United States - New Jersey Manufacturers Insurance Company
Description
NJM Insurance Group (NJM), a top-rated insurance company, is looking for a Personal Injury Protection Representative who has excellent communication skills as well as strong organizational and time management skills. We are looking for talent with and without prior experience in the insurance industry.
Schedule: Monday through Friday, with work from home opportunities after training.
PIP Claims Representative:
Reporting to the immediate designated PIP Supervisor, the PIP claims representative is responsible and accountable for conducting complete and thorough investigation on assigned claims and medically managing those claims throughout their life cycle.
Salary Range: $48,000 - $56,000 annually. Salary is commensurate with experience and credentials.
This role may be filled at a Level II or Senior level based on skills, experience and credentials.
Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
