Claims – No-Fault Litigation Specialist I - IV

Literature

• Provide technical direction and support to med pay and PIP claims examiners.
• Develop and implement training programs related to auto med pay and PIP.
• Participate in coverage analysis for assigned claims.
• Manage litigation on assigned files.
• Evaluate exposure and set reserves in excess of $100,000.
• Investigate and adjust medical component of first party auto claims.
• Work collaboratively with Field Claims associates.
• Communicate directly with policyholders and other external contacts.
• Enter information and documentation into Claims Management System.
• Review medical records and medical billings, issuing payments as appropriate.
• Actively oversee Medicare filings to ensure compliance with reporting requirements.

Qualifications

• Excellent customer service to internal and external customers.
• Excellent problem-solving, attention to detail, decision making, time management and organizational skills.
• Initiative in assisting and educating other associates.
• Willingness to take on new responsibilities as deemed necessary.
• Masters principles and strategies for maintaining professional and respectful relationships with all stakeholders.

Education

• AIC, CPCU, SCLA designations or other relevant education.