PIP Claims Representative

CURE Auto Insurance; Princeton (NJ); Hybrid; USD 58,000 - 77,000; Full time

Benefits offered by this job

Health and dental coverage

Life and disability insurance

401(k) with company match

PTO and holidays

Job summary

CURE Auto Insurance in Princeton, NJ is seeking a PIP Claims Representative to investigate, evaluate, and disposition complex Personal Injury Protection claims by settlement, payment, or denial.

You will verify coverage, conduct thorough investigations, determine eligibility and damages, maintain reserves, coordinate with medical experts, and ensure adherence to company policies and regulatory requirements in a hybrid on-site/remote work model.

Qualifications

• Bachelor's degree or commensurate experience in the insurance industry or customer service.
• Must have excellent customer service skills; ability to multitask, analyze coverages, liability and damages.

Responsibilities

• Receive assigned claims, verify coverage, confirm eligibility and determine course of action.
• Conduct thorough claim investigations through telephone and written communication.
• Evaluate information to determine PIP eligibility and injury/claim exposure.
• Establish reserves and coordinate with medical case managers or experts as needed.
• Handle inquiries from subscribers, attorneys, and providers; document files and maintain diary system.

Skills

Customer service

Multitasking

Coverage analysis

Liability assessment

Education

Bachelor's degree or equivalent

Job description

Salary Range: $58,240.00 To $76,960.00 Annually

PIP Claims Representative

CURE Auto Insurance is a leading direct writer of auto insurance in New Jersey, Pennsylvania, and Michigan. CURE offers a great working environment, competitive salary, and comprehensive benefits package which includes health and dental coverage, life and disability insurance, 401k with generous company match, and much more!

The PIP Claims Representative will handle the investigation, evaluation and disposition by settlement, payment, or denial of complex Personal Injury Protection claims. Ensure that claims are processed within company policies, procedures, regulatory requirements, and the individual's prescribed authority with high standards of performance.

Essential Job Functions

Receive assigned claims, verify coverage, confirm eligibility and determine course of action.

Complete detailed, thorough claim investigation through telephone and/or written correspondence with subscribers, attorneys, witnesses and any others with information relevant to the claim.

Analyze information obtained through investigation in order to evaluate the claim, determine PIP eligibility and determine the extent of the injuries and claim exposure.

Establish and maintain the proper reserves for the exposure.

Assign medical case managers or other experts to a case when appropriate and arrange for independent medical examinations when necessary to determine medical necessity and causal relationship of treatment.

Handle incoming calls and correspondence from subscribers, claimants, attorneys and providers regarding questions or problems associated with a claim.

Document claim files and maintain a diary system for reporting and claim follow-up.

Handle claims in accordance with CURE's Decision Point Review Plan.

Work closely with the Special Investigation Unit, Underwriting Department, attorneys, and other members of the Claim Department to ensure that CURE achieves optimum results on all files.

Manages allocated loss adjustment expense. Employs outside vendors when activities cannot be completed by a staff member and directs the activities of vendors to ensure only necessary work is completed

Comply with all conditions outlined in the Unfair Claim Practices Acts.

Perform other duties as assigned.

Requirements

Education: Bachelor's degree or commensurate experience in the insurance industry or customer service

Years/Type of Experience: A minimum of 2 years customer service or commensurate medical experience preferred.

Specific Skills: Must have excellent customer service skills; the ability to multitask, analyze coverages, liability and damages.

Other Required or Preferred Qualifications: Detail oriented with strong written and verbal communication skills. Must be able to work independently as well as possess strong interpersonal skills necessary to contribute as a team player.

Generous paid time off (PTO days, sick days, and holidays)

Flexible spending options with FSA & HSA plans

Life and AD&D insurance

401(k) with company match

Voluntary benefits such as legal services, pet insurance, and identity & fraud protection

24/7 Employee Assistance Program (EAP) for employees and their families

Health & wellness perks including gym discounts, wellness reimbursements, and reward programs

• Fun, engaging in-office events that support our culture

Schedule: We offer flexible work hours between 8:00 AM and 5:00 PM, and employees can choose a schedule that works best for them—8:00 AM–4:00 PM, 8:30 AM–4:30 PM, or 9:00 AM–5:00 PM. While we aim to support individual preferences, final schedules may be adjusted based on business needs to ensure great coverage and teamwork.

We offer a hybrid work schedule: team members work onsite 4 days per week and have the flexibility to work remotely 1 day per week.

Location: Detroit, MI or Princeton, NJ

We recruit, hire, employ, train and promote, and compensate individuals based on job-related qualifications and abilities. We respect the dignity and worth of each individual and are committed to an employment environment that is free from all forms of employment discrimination.

CURE Auto Insurance provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, pregnancy, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Disclaimer : This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned. This job description may be subject to change at any time.

Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.