Claims Representative I, PIP (IA Channel)

About the role

In this fast-paced role, the PIP Representative adjusts first party personal injury claims according to state compliance requirements and guidelines.

Responsibilities

• Handle Personal Injury Protection and Extended Medical Expense Benefit claims in multiple states.
• Receive between 3 to 5 first reports a day with priority on service, patient contact, and claim disposition.
• Perform first reports, Image Right tasks, medical bill review, treatment monitoring, reserve assessment, and nursing interaction.
• Maintain an effective follow-up system on pending files.
• Prioritize and handle multiple tasks simultaneously; adjust to fluctuating workload.
• Advise injured parties as to the status of the claim.
• Investigate and interpret policy provisions and conditions to make coverage determinations.
• Ensure service, loss, and expense control are maintained at all times.
• Adhere to privacy guidelines, law, and regulations pertaining to claims handling.
• Possess strong customer service, organization, verbal and written skills; ability to work in a small team environment.
• Ability to multitask in time‑sensitive situations.
• Functional knowledge of medical terminology and anatomy with a thorough understanding of Personal Injury Protection claim handling regulatory requirements (preferred but not necessary).

Qualifications

• Bachelor’s Degree (B.A.) from a four‑year college or university.
• One to three years of related claims experience and/or training.
• Basic personal computer skills including working knowledge of Microsoft Office Suite products.

Benefits

• 4 weeks accrued paid time off + 9 paid national holidays per year.
• Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision).
• Annual 401(k) Employer Contribution.
• Free onsite gym and health center at the Woodbridge location.
• Resources to promote professional development (LinkedIn Learning and licensure assistance).
• Robust health and wellness program and fitness reimbursements.
• Various paid family leave options including paid parental leave.
• Tuition reimbursement.

Pay

The pay range for this position is $57,000 to $76,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.