FL Auto PIP & Medical Claims Specialist

Loyalty MGA LLC; Miami (FL); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Competitive base pay

Paid Time Off

Medical Insurance

Sick Time

Dental & Vision

Performance Bonus

401(k) with Match

Training & Development

Job summary

Loyalty MGA LLC is seeking a Florida Auto PIP / Medical Payments Adjuster to join our claims team in Miami. You will review medical bills, apply PIP statutes, and communicate with insureds and providers to ensure timely, accurate payments.

The role requires knowledge of Florida PIP regulations, strong organizational skills, and the ability to handle a high-volume caseload while maintaining compliance with company policies.

Qualifications

• Some Florida PIP or Medical Payments claims handling experience.
• Some knowledge of Florida PIP statutes and fee schedules.
• Experience reviewing medical bills and medical documentation.
• Excellent organizational and time management skills.
• Strong bilingual written and verbal communication skills.
• Ability to work independently and manage a high-volume caseload.

Responsibilities

• Review medical bills, records, and documentation for accuracy and compliance.
• Apply Florida PIP statutes and fee schedules to determine appropriate payments.
• Communicate with insureds, claimants, attorneys, and medical providers.
• Negotiate good faith settlements with providers' offices.
• Document claim activity and maintain accurate claim files.
• Issue payments and explanations of benefits (EOBs) as appropriate.
• Identify potential fraud indicators and escalate when necessary.
• Maintain compliance with company procedures and regulatory requirements.
• Manage claim workload to meet productivity and quality standards.

Skills

PIP claims

Medical payments

Medical bills review

Organizational skills

Bilingual communication

Independent work

High-volume caseload

Claims system experience

Education

Florida Adjuster License (620)

Tools

Claims system

Job description

Loyalty MGA LLC is seeking a Florida Auto PIP / Medical Payments Adjuster to join our claims team in Miami. You will review medical bills, apply PIP statutes, and communicate with insureds and providers to ensure timely, accurate payments.

The role requires knowledge of Florida PIP regulations, strong organizational skills, and the ability to handle a high-volume caseload while maintaining compliance with company policies.