Claims Representative I, PIP

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

Benefits offered by this job

4 weeks PTO + 9 holidays

Health insurance from Day 1

401(k) employer contribution

Onsite gym and health center

Professional development resources

Wellness program and fitness reimburse

Paid family leave options

Job summary

Plymouth Rock Assurance is seeking a PIP Representative in New Jersey. The role handles first-party Personal Injury Protection and related claims, with 3–5 reports per day, focusing on service, contact with patients, and claim disposition.

Responsibilities include medical bill review, treatment monitoring, reserve assessment, and nursing interaction, while ensuring privacy and regulatory compliance. Strong customer service and teamwork are essential.

Qualifications

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

Responsibilities

• Handle Personal Injury Protection and Extended Medical Expense Benefit claims across multiple states
• Process 3–5 first reports daily prioritizing service and timely disposition
• Review medical bills, monitor treatment, adjust reserves, and coordinate with nursing staff
• Maintain an effective follow-up system and multitask in a time-sensitive environment
• Investigate policy provisions to determine coverage and apply regulatory requirements
• Demonstrate knowledge of medical terminology and PIP claim handling rules
• Ensure privacy guidelines and laws are followed in claims handling
• Communicate clearly with injured parties about claim status and next steps

Skills

Customer service

Time management

Verbal communication

Written communication

Teamwork

Education

Bachelor's degree (B.A.)

Tools

Microsoft Office

Job description

In this fast-paced role, the PIP Representative 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 $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