Claims Representative I, PIP

plymouthrock; Port Reading (NJ); On-site; USD 57,000 - 76,000; Full time

Benefits offered by this job

4 weeks accrued paid time off + 9 paid

health insurance

401(k) with employer contribution

Onsite gym and health center

Professional development resources

Wellness program and fitness reimburse

Paid family leave options

Tuition reimbursement

Job summary

The Plymouth Rock Company is seeking a PIP Claim Representative in Port Reading, NJ, to adjust first-party personal injury claims in line with state regulations. You will manage PIP and Extended Medical Expense Benefit claims, process initial reports, review medical bills, monitor treatment, and keep claimants informed.

Ideal candidates have a Bachelor’s degree and 1–3 years of related claims experience, plus solid Microsoft Office skills.

Qualifications

• Bachelor’s degree from a four-year college or university.
• 1–3 years of related claims experience and/or training.
• Basic PC skills including Microsoft Office Suite.

Responsibilities

• Adjust first party personal injury claims in compliance with state guidelines.
• Handle PIP and Extended Medical Expense Benefit claims across multiple states.
• Process first reports, image rights tasks, medical bill review, and treatment monitoring.
• Maintain follow-up on pending files and manage multiple tasks in a team.
• Investigate policy provisions to determine coverage determinations.
• Apply knowledge of medical terminology to PIP claim handling rules.
• Multitask in time-sensitive situations while ensuring service quality.
• Ensure service, loss, and expense controls are maintained.
• Adhere to privacy laws and regulations in claims handling.
• Demonstrate strong customer service, organization, and written/verbal skills in a small team.

Skills

Customer service

Organization

Verbal communication

Written communication

Education

Bachelor's degree (B.A.)

Job description

RESPONSIBILITIES

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

• 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 $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.

PERKS & 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 our 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

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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