Claims Representative I, PIP

plymouthrock; Mount Laurel Township (NJ); On-site; USD 54,000 - 72,000; Full time

Benefits offered by this job

4 weeks paid time off + 8 holidays + 2

Health insurance from Day 1

401(k) employer contribution

Professional development support

Wellness program & fitness reimburse

Paid family leave options

Tuition reimbursement

Job summary

Plymouth Rock is seeking a PIP Representative to adjust first party personal injury claims in line with state compliance requirements and guidelines. This role handles PIP claims in multiple states, processes first reports, medical bill review, treatment monitoring, and coverage determinations, with an emphasis on service, patient contact, and timely claim disposition.

The position offers a competitive salary range and robust benefits, including health insurance, PTO, and 401(k) contributions,

Qualifications

• Bachelor's degree from a four-year college or university.
• One to three years of related claims experience or training.
• Basic PC skills including Microsoft Office.

Responsibilities

• Handle Personal Injury Protection and Extended Medical Expense Benefit claims in multiple states.
• Receive 3–5 first reports per day with emphasis 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 and manage multiple tasks in a small team.
• Investigate and interpret policy provisions to make coverage determinations.
• Apply knowledge of medical terminology and PIP regulatory requirements as needed.
• Multitask in time-sensitive situations while ensuring privacy guidelines are followed.

Skills

Microsoft Office

Education

Bachelor's Degree

Job description

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

RESPONSIBILITIES

• This position will handle Personal Injury Protection and Extended Medical Expense Benefit claims in multiple states.
• The PIP Claim Representative will receive between 3 to 5 first reports a day with a priority on service, patient contact, and claim disposition.
• Daily duties include first reports, Image Right tasks, medical bill review, treatment monitoring, reserve assessment and Nursing interaction.
• Maintains an effective follow-up system on pending files, prioritize and handle multiple tasks simultaneously, adjust to fluctuating workload, advises injured parties as to the status of the claim.
• Investigates and interprets policy provisions and conditions to make a coverage determination.
• Functional knowledge of medical terminology and anatomy with a thorough understanding of Personal Injury Protection claim handling regulatory requirements is preferred but not necessary.
• The PIP Claim Representative must have the ability to multitask in time sensitive situations.
• Ensures that service, loss and expense control are maintained at all times.
• Adheres to privacy guidelines, law and regulations pertaining to claims handling.
• Candidates must have strong customer service, organization, verbal and written skills and have the ability to work in a small team environment.

QUALIFICATIONS

• A Bachelor’s Degree (B.A.) from a four-year college or university.
• One (1) to three (3) years related claims experience and/or training.
• Basic personal computer skills including working knowledge of Microsoft Office Suite products.

SALARY RANGE

The pay range for this position is $53,500 to $71,500 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.

PERKS & BENEFITS

• 4 weeks accrued paid time off, 8 paid national holidays per year. and 2 floating holidays
• Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
• Annual 401(k) Employer Contribution
• 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

ABOUT THE COMPANY

The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of "A-/Excellent".
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