PIP Claims Handler

This is a remote position. Position Summary We are seeking an experienced PIP Claims Handler to manage and investigate Personal Injury Protection (PIP) claims related to automotive accidents. This role is heavily focused on reviewing claims for accuracy, identifying inconsistencies, mitigating fraud exposure, and controlling claim costs while ensuring compliance with state regulations and policy requirements. The ideal candidate has extensive experience handling PIP claims within the auto insurance, legal, healthcare billing, or claims administration space and is highly skilled at scrutinizing medical documentation, billing practices, and treatment timelines. This position requires strong analytical ability, attention to detail, and confidence in challenging questionable claims, excessive billing, or unsupported treatment. Essential Duties and Responsibilities (include, but are not limited to the following): Key Responsibilities This role primarily handles PIP claims arising in Maryland, with regular exposure to Pennsylvania, Florida, Georgia, Illinois, Virginia, and the District of Columbia. Familiarity with the regulatory frameworks in any of these states is strongly preferred; mastery of Maryland PIP is requiredReview, investigate, and manage PIP claims from initial notice through resolutionAnalyze medical records, treatment plans, billing submissions, police reports, and supporting documentationIdentify billing irregularities, excessive treatment patterns, duplicate charges, inflated claims, or potential fraud indicatorsEvaluate claim validity and determine exposure based on applicable state PIP regulations and policy guidelinesDefend against inaccurate, unsupported, or excessive claims through detailed file review and documentationCoordinate with attorneys, medical providers, adjusters, third-party administrators, and internal stakeholdersNegotiate settlements and reductions with providers, attorneys, and claimants when appropriateMonitor claim timelines and ensure all statutory deadlines and compliance requirements are metPrepare detailed claim notes, summaries, and recommendations for leadership or legal reviewAssist with litigation support and respond to disputes, arbitrations, or audits related to PIP claimsIdentify trends and recommend process improvements to reduce claim leakage and financial exposureMaintain accurate claim files and documentation within internal systems Qualifications Required 3+ years of direct experience handling automotive PIP claimsStrong knowledge of PIP regulations, medical billing review, and claims investigation practicesExperience defending against questionable or inflated PIP claimsAbility to interpret medical records, treatment documentation, and billing codesExperience in identifying fraud indicators, provider abuse, or claim inconsistenciesStrong negotiation and conflict-resolution skillsExcellent organizational skills and attention to detailAbility to manage a high-volume caseload while maintaining accuracyProficient in claims management systems and Microsoft Office / Google Workspace Preferred Qualifications Experience in rideshare, fleet, rental, or commercial auto claims environmentsPrior experience working with SIU (Special Investigations Unit) teamsFamiliarity with state-specific PIP regulations, especially high-volume PIP statesExperience working with attorneys and litigation managementInsurance adjuster license(s) where applicable Salary: $65,000 - $70,000 per year; depending on experience Ideal Candidate Profile The ideal candidate is highly detail-oriented, skeptical in the right ways, and comfortable challenging unsupported claims or questionable documentation. They should be able to balance thorough investigation with efficient claim handling and understand how to reduce unnecessary claim spend without compromising compliance or professionalism.