Claims Representative I, PIP (IA Channel)

Plymouth Rock Company; Port Reading, Northern (NJ, KY); Hybrid; USD 57,000 - 76,000; Full time

Benefits offered by this job

Paid time off

Health insurance

401(k) contribution

Onsite gym

Professional development

Wellness program

Paid family leave

Tuition reimbursement

Job summary

Plymouth Rock Company in Woodbridge, New Jersey seeks a Claims Representative I, PIP (IA Channel) to adjust first-party personal injury claims in line with state guidelines.

The role requires handling PIP and related medical claims across states, processing reports daily, and maintaining excellent customer service while ensuring privacy and regulatory compliance.

Qualifications

• Bachelor’s degree required.
• 1–3 years related claims experience.
• Basic computer skills including MS Office.

Responsibilities

• Handle Personal Injury Protection and Extended Medical Expense Benefit claims in multiple states.
• Process 3–5 first reports per day with focus on service and claim disposition.
• Perform medical bill review, treatment monitoring, reserve assessment, and nursing interactions.
• Maintain follow-up on pending files and manage multiple tasks in a time-sensitive environment.
• Interpret policy provisions to determine coverage and adhere to privacy regulations.

Skills

Customer service

Multi-tasking

Time management

Verbal & written communication

Education

Bachelor’s Degree

Tools

Microsoft Office Suite

Job description

Claims Representative I, PIP (IA Channel)

#26-1620

Woodbridge, New Jersey, United States

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
• 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”. #LIDNI

Location(s)

581 Main Street, Woodbridge , New Jersey 07095 , United States

Plymouth Rock is committed to a policy ofnon-discrimination and equal opportunity for all qualified applicants andemployees without regard to race, color, religion, gender, sexual orientation,age, national origin, ancestry or disability.