Senior Personal Injury Protection Adjuster

Key Responsibilities

• Review and assess PIP claims to determine coverage, liability, and the extent of injuries.
• Conduct thorough investigation into the circumstances surrounding each claim, including obtaining medical records, police reports, and statements.
• Evaluate the nature and severity of injuries reported by first-party claimants through medical documentation, diagnostic tests, and expert opinions.
• Determine the applicability of PIP coverage based on policy terms, state regulations, and the specifics of each claim.
• Negotiate fair and equitable settlements with claimants, attorneys, and medical providers to resolve claims effectively.
• Maintain detailed and accurate records of claim files, including correspondence, investigation findings, settlement offers, and payment transactions.
• Communicate effectively with first-party claimants, legal representatives, medical providers, and other stakeholders to provide updates, address concerns, and facilitate the claims process.
• Ensure compliance with all relevant laws, regulations, and company policies throughout the claims handling process.
• Provide exceptional customer service to first-party claimants by addressing inquiries promptly and offering assistance throughout the claims process.
• Manage pre-authorization requests and identify cases requiring an IME.
• Stay abreast of industry trends, legal developments, and medical advancements relevant to PIP claims to enhance expertise and effectiveness in the role.
• Complete a detailed analysis of claims where a new suit has been received inclusive of coverage, liability, and damages.
• Manage and oversee litigation processes, working closely with legal counsel to develop strategies for case resolution.

Qualifications

• Bachelor's degree or equivalent work experience
• Previous experience in auto claim adjusting, preferably with a focus on commercial PIP claims in NJ and PA.
• Previous experience with AICRA in New Jersey and MVFRL in PA.
• Strong knowledge of insurance principles, coverage types, and regulations governing PIP.
• Excellent analytical skills with the ability to assess complex situations and make informed decisions.
• Effective negotiation skills and the ability to resolve conflicts and disputes.
• Exceptional communication skills, both verbal and written, and the ability to convey information clearly and concisely.
• Detail-Oriented with strong organizational and time management skills.
• Proficiency in relevant software applications for claims management and documentation.
• Previous litigation experience is preferred but not required.
• Prior Non-Standard Auto Claims experience a plus, not required.

Benefits

• Competitive Salaries
• Commitment to your Training & Development
• Medical and Dental
• Telemedicine Benefit
• 401k with a generous company match
• Paid Time Off and Paid Holidays
• Tuition Reimbursement Training Programs
• Wellness Program
• Fun company sponsored events
• And so much more!

Pay

Estimated Compensation Range: $54,750/year-$97,500/year*

*Published ranges are estimates