Claims Customer Service First Party Medical

About the role

CURE Auto Insurance is a leading direct writer of auto insurance in New Jersey, Pennsylvania, and Michigan. We offer a great working environment, competitive salary, and comprehensive benefits package which includes health and dental coverage, life and disability insurance, 401k with generous company match, and much more!

Responsibilities

• Receive assigned claims, verify coverage, confirm eligibility and determine course of action.
• Complete detailed, thorough claim investigation through telephone and/or written correspondence with subscribers, attorneys, witnesses and any others with information relevant to the claim.
• Analyze information obtained through investigation in order to evaluate the claim, determine PIP eligibility and determine the extent of the injuries and claim exposure.
• Establish and maintain the proper reserves for the exposure.
• Assign medical case managers or other experts to a case when appropriate and arrange for independent medical examinations when necessary to determine medical necessity and causal relationship of treatment.
• Handle incoming calls and correspondence from subscribers, claimants, attorneys and providers regarding questions or problems associated with a claim.
• Document claim files and maintain a diary system for reporting and claim follow-up.
• Handle claims in accordance with CURE's Decision Point Review Plan.
• Work closely with the Special Investigation Unit, Underwriting Department, attorneys, and other members of the Claim Department to ensure that CURE achieves optimum results on all files.
• Manage allocated loss adjustment expense. Employ outside vendors when activities cannot be completed by a staff member and direct the activities of vendors to ensure only necessary work is completed.
• Comply with all conditions outlined in the Unfair Claim Practices Acts.
• Perform other duties as assigned.

Requirements

• Education: Bachelor's degree or commensurate experience in the insurance industry or customer service
• Years/Type of Experience: A minimum of 2 years customer service or commensurate medical experience preferred.
• Specific Skills: Must have excellent customer service skills; the ability to multitask, analyze coverages, liability and damages.
• Other Required or Preferred Qualifications: Detail oriented with strong written and verbal communication skills. Must be able to work independently as well as possess strong interpersonal skills necessary to contribute as a team player.

Benefits

• Comprehensive health benefits including medical, dental and vision coverage
• Generous paid time off (PTO days, sick days, and holidays)
• Flexible spending options with FSA & HSA plans
• Life and AD&D insurance
• 401(k) with company match
• Voluntary benefits such as legal services, pet insurance, and identity & fraud protection
• 24/7 Employee Assistance Program (EAP) for employees and their families
• Health & wellness perks including gym discounts, wellness reimbursements, and reward programs
• Fun, engaging in-office events that support our culture

Pay

$58,240 - $76,960

Schedule

We offer flexible work hours between 8:00 AM and 5:00 PM, and employees can choose a schedule that works best for them—8:00 AM–4:00 PM, 8:30 AM–4:30 PM, or 9:00AM–5:00 PM. While we aim to support individual preferences, final schedules may be adjusted based on business needs to ensure great coverage and teamwork. We offer a hybrid work schedule: team members work onsite 4 days per week and have the flexibility to work remotely 1 day per week.

Location

Location: Detroit, MI or Princeton, NJ