Jobs
>
Miami

    Medical Management Specialist - Miami, United States - United Auto Insurance

    United Auto Insurance
    United Auto Insurance Miami, United States

    2 weeks ago

    Default job background
    Description

    Job Description

    Job Description

    COMPANY OVERVIEW:

    Founded in 1989, United Automobile Insurance Company is an innovative and established organization looking for a PIP Medical Management Adjuster to join our team. Family-owned, UAIC, is one of the largest privately held property and casualty insurance companies in the United States. The key to our growth and success is a commitment to providing quality service to our agents and customers, by providing disciplined underwriting, and strategic claims handling. Our ongoing efforts to invest substantial resources in personnel and technology are the foundation of our promise of assuring maximum efficiency and specialized operations in the industry. We are proud that our independent agents and customers have recognized our dedication by making UAIC the market leader in every state where we conduct business.

    SCOPE:

    As a PIP Medical Management Specialist, you will play a pivotal role in processing claims within the realm of personal injury protection ensuring that injured parties receive appropriate medical care. The primary responsibility of this role is to manage and oversee the medical claims process for individuals who have been injured in automobile accidents. The goal is to ensure that injured parties receive appropriate medical treatment while adhering to the terms and regulations of the insurance policy. This position offers a remote work arrangement, allowing the ideal candidate to work from their preferred location within the Southeast region.

    DUTIES:

    • Assess the validity of claims based on policy terms, accident details, and medical documentation.
    • Coordinate with medical providers, policyholders, and claimants to gather necessary information for claims processing.
    • Collaborate with medical professionals to evaluate the extent and necessity of medical treatment required for claimants' injuries.
    • Ensure that the medical treatment being sought aligns with the injuries sustained in the accident and is reasonable and necessary.
    • Interpret insurance policies to determine coverage limits and guidelines for medical treatment under the PIP coverage.
    • Verify that medical treatments and services are within the coverage scope outlined in the insurance policy.
    • Review medical bills and invoices to confirm the accuracy and reasonableness of charges.
    • Identify and refer potential indicators to our Special Investigations Unit (SIU) for additional assistance.
    • Accurate recognition of other relevant claims exposures.
    • Ensure timely provision of PIP payment logs, claim details, policy data, and payment records in accordance with legal deadlines.
    • Process payments for medical services according to the insurance policy's guidelines.
    • Negotiate medical bills and fees with medical providers to ensure fair and reasonable pricing for services rendered.
    • Reach settlements with medical providers and claimants, considering policy limits and coverage.
    • Maintain detailed records of all interactions, assessments, decisions, and communications related to each claim.
    • Uses claims systems to maintain claim information, addresses diaries, correspondences, emails, and voicemails within established time frame.
    • Communicate with claimants and policyholders regarding the status of their claims, required documentation, and any decisions made.
    • Address questions, concerns, and inquiries in a professional and timely manner.
    • Stay up to date with industry regulations and changes in laws related to personal injury protection and medical claims processing.
    • Collaborate with other members of the claims team (i.e., attorneys) to ensure accurate and effective claims management.
    • Identify opportunities for process improvement within the claims management process to enhance efficiency and customer satisfaction.

    EDUCATION:

    • Bachelor's degree in a relevant field (e.g., business or healthcare) is preferred.
    • Adjusters license required.
    • Bilingual preferred

    SKILLS & EXPERIENCE:

    • 1-2+ years of adjusting experience within the auto insurance sector.
    • 1-year proficiency in handling Florida Personal Injury Protection claims.
    • Strong understanding of insurance policies, medical terminology, and billing practices.
    • Excellent communication skills for dealing with claimants, medical professionals, and internal teams.
    • Attention to detail and strong analytical skills for reviewing medical records and bills.
    • Ability to work independently, make sound judgments, and handle multiple claims simultaneously.
    • Proficient in Word, Excel, Windows-based applications, and internet usage.
    • Knowledge of legal and regulatory requirements related to personal injury claims is beneficial.

    BENEFITS:

    • 401(k) Retirement Savings Plan with employer match.
    • Comprehensive Medical, Prescription Drug, Vision, and Dental Insurance
    • Paid Time Off, Holidays, and Leave programs.
    • Flexible spending accounts
    • Basic Life Insurance and Voluntary Life/ADD
    • Voluntary Short Term and Long-Term Disability

    Please note that the salary range listed is an estimate provided by the job board and might not align with accurate information. The actual salary for this position may vary based on experience and qualifications. Candidates are encouraged to discuss compensation during the interview process.

    UAIC is an Equal Opportunity Employer and is committed to the principle of equal employment opportunity for all employees. All employment decisions at UAIC are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, belief, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.

    Powered by JazzHR

    FftiPXRqtS

  • Del Monte Fresh Produce Company NA Inc

    Product Management Specialist

    3 weeks ago

    Del Monte Fresh Produce Company NA Inc Miami, United States

    Job Description · Job DescriptionAccountabilities: · This position is responsible for product coordination between sales, ports of entry, and production areas for DM's Core Products. · Coordinates inventory management of North America ports the commodity and supports the sales t ...

  • U.S. Department of the Interior

    Housing Management Specialist

    2 weeks ago

    U.S. Department of the Interior El Portal, United States

    Clarification from the agency · This announcement is open to current and former Federal career/career-conditional employees in the Competitive service, Reinstatement eligibles, Eligible Veterans, CTAP & ICTAP eligibles, Land Management Workforce Flexibility Act (LMWFA) eligibles ...

  • Trax USA Corp.

    Project Management Specialist

    2 weeks ago

    Trax USA Corp. Miami, United States

    : · **Position Overview**: · This position requires excellent communication, organizational and interpersonal skills to collaborate with clients/internal teams and to coordinate and track project activities, opportunities, and risks. The Project Management Specialist will work cl ...

  • Del Monte Fresh Produce Company NA Inc

    Product Management Specialist

    2 weeks ago

    Del Monte Fresh Produce Company NA Inc Miami, United States

    Job Description · Job DescriptionAccountabilities: · This position is responsible for product coordination between sales, ports of entry, and production areas for DM's Core Products. · Coordinates inventory management of North America ports the commodity and supports the sales t ...

  • The Judge Group

    Product Management Specialist

    22 hours ago

    The Judge Group Coral Gables, United States

    Accountabilities:This position is responsible for product coordination between sales, ports of entry, and production areas for DM's Core Products. Coordinates inventory management of North America ports the commodity and supports the sales team in their day-to-day sales/ tasks to ...

  • Elevance Health

    Medical Management Specialist I

    4 weeks ago

    Elevance Health Miami, United States Full time

    · Anticipated End Date: · Position Title: · Medical Management Specialist I · Job Description: · Medical Management Specialist I · Location: Tampa, FL or Miami, FL · This position is primarily work from home but requires you to be located within 50 miles of Tampa, FL or Miami, F ...

  • Aurora Technologies

    Training in the high school program for retail

    1 week ago

    Aurora Technologies Miami, United States

    Location: 59199 Bönen | Employment Type: Full-time, temporary | Job ID: 802391 · Start of Training: | Planned End of Training: · PENNY is part of the REWE Group and employs over employees in around 2,140 stores, 10 logistics locations, and the headquarters. In the PENNY team, we ...

  • Quantum Dynamics

    An Account Manager is a professional responsible for managing and maintaining relationships with clients or customers. They are typically in charge of overseeing the sales and service of a particular account or group of accounts

    1 week ago

    Quantum Dynamics Miami Beach, United States

    Introduction · For our branch in Miami Beach, we are looking for your strong support. Join us in our core competency: SAUTER creates living spaces for the future. · Your tasks · Supporting a customer base of planners, plant builders, operators, and project developers · Creating i ...

  • Omega Enterprises

    Training for Office Management Clerk

    1 week ago

    Omega Enterprises North Miami, United States

    Training for Office Management Assistants (m/f/d) in North MiamiAre you looking for a training profession that opens all doors for you? Office management assistants are true all-rounders and indispensable in any office. With a training at our company, you will also become a speci ...

  • Skyline Enterprises

    Fleet Management Clerk

    1 week ago

    Skyline Enterprises Miami, United States

    Tevex Logistics GmbH - a part of the Tönnies Group Your Responsibilities Handling of accident damage Prevention measures to minimize damage Independent processing of orders and invoicing Independent review and processing of invoices Assisting with general administrative tasks Man ...

  • Sapphire Solutions

    Training for professional driver

    1 week ago

    Sapphire Solutions Miami, United States

    Training for Professional Driver (m/w/d) 2024 in Miami · Industry · Training/Dual Studies · Employment Type · Training/Dual Studies · Location · Miami · About Us · The Geis Group, headquartered in Bad Neustadt a.d. Saale, is a global full-service logistics provider with over empl ...

  • Delmonte Fresh Produce

    Product Management Specialist

    2 weeks ago

    Delmonte Fresh Produce Coral Gables, United States

    Accountabilities:This position is responsible for product coordination between sales, ports of entry, and production areas for DM's Core Products. Coordinates inventory management of North America ports the commodity and supports the sales team in th Product Management, Specialis ...

  • Fresh Del Monte Inc.

    Product Management Specialist

    3 weeks ago

    Fresh Del Monte Inc. Coral Gables, United States

    If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. · Product Management Specialist · Full Time · Coral Gables-HQ, Coral Gables, FL, US · 5 days ago · Requisition ID: 1904 ...

  • Fresh Del Monte

    Product Management Specialist

    1 week ago

    Fresh Del Monte Coral Gables, United States

    Accountabilities: · This position is responsible for product coordination between sales, ports of entry, and production areas for DM's Core Products. · Coordinates inventory management of North America ports the commodity and supports the sales team in their day-to-day sales/ tas ...

  • Fresh Del Monte

    Product Management Specialist

    1 week ago

    Fresh Del Monte Coral Gables, United States

    Accountabilities: · This position is responsible for product coordination between sales, ports of entry, and production areas for DM's Core Products. · Coordinates inventory management of North America ports the commodity and supports the sales team in their day-to-day sales/ t ...

  • Fresh Del Monte

    Product Management Specialist

    1 week ago

    Fresh Del Monte Coral Gables, United States

    Accountabilities: · This position is responsible for product coordination between sales, ports of entry, and production areas for DM's Core Products. · Coordinates inventory management of North America ports the commodity and supports the sales team in their day-to-day sales/ tas ...

  • Del Monte Fresh Produce Company NA Inc

    Product Management Specialist

    2 days ago

    Del Monte Fresh Produce Company NA Inc Doral, United States

    Job Description Job Description Accountabilities:This position is responsible for product coordination between sales, ports of entry, and production areas for DM's Core Products.Coordinates inventory management of North America ports the commodity and supports the sales team in t ...

  • Del Monte Fresh Produce Company NA Inc

    Product Management Specialist

    2 weeks ago

    Del Monte Fresh Produce Company NA Inc Doral, United States

    Job Description · Job Description · Accountabilities: · This position is responsible for product coordination between sales, ports of entry, and production areas for DM's Core Products. · Coordinates inventory management of North America ports the commodity and supports the sal ...

  • National Park Service

    Housing Management Specialist

    3 weeks ago

    National Park Service El Portal, United States Full time

    Manages approximately 400 geographically dispersed housing which include both required and permitted occupants. · Coordinates between the housing office and the fiscal office to facilitate the timely and accurate billing of rent and other bills of collection generated by housing ...

  • Del Monte Fresh Produce

    Product Management Specialist

    1 month ago

    Del Monte Fresh Produce Coral Gables, United States Full time

    Accountabilities: · This position is responsible for product coordination between sales, ports of entry, and production areas for DM's Core Products. · Coordinates inventory management of North America ports the commodity and supports the sales team in their day-to-day sales/ ta ...