PIP Claims Representative- Gainesville, FL

Florida Farm Bureau Insurance; Gainesville (FL); On-site; USD 36,000 - 45,000; Full time

Benefits offered by this job

Health

Dental

Vision

PTO

Illness Leave

Pension

401K Matching

Job summary

Florida Farm Bureau Insurance in Gainesville, FL, seeks a PIP Claims Representative to manage and adjust medical insurance claims under Personal Injury Protection and Medical Payments coverage. You will ensure timely, accurate processing while complying with regulations and company standards.

Starting salary is $40,500 with full benefits. You will review, investigate, and process PIP/Medpay claims, determine coverage, verify medical necessity, gather documentation, and maintain detailed claim

Qualifications

• H.S. Diploma is required.
• Must obtain Adjuster's license within 6 months.
• Customer service experience.
• Familiarity with medical terminology & treatment protocols.

Responsibilities

• Review, investigate, and process PIP and Medpay claims.
• Determine coverage eligibility, verify medical necessity, and assess reasonableness of charges.
• Communicate with claimants, medical providers, attorneys, etc. to gather necessary documentation to resolve claims.
• Maintain detailed and accurate claim files and documentation.
• Provide clear and empathetic communication to claimants and stakeholders.
• Address inquiries and resolve issues promptly and professionally.
• Prepare reports and summaries for management as needed.
• Regular and predictable attendance is required.

Skills

English communication

Customer service

Typing 50 wpm

Strong math

Proficient PC skills

Education

High School Diploma

Adjuster's license within 6 months

Job description

This job is with Florida Farm Bureau which is the Florida state office for Southern Farm Bureau Casualty Insurance Company, and we currently have an opening for a PIP Claims Representative to work in Gainesville, FL. This position is responsible for managing and adjusting medical insurance claims under Personal Injury Protection and/or Medical Payments coverage. In this role you will ensure timely and accurate processing of claims while maintaining compliance with regulatory requirements and company standards. Starting salary of $40,500. We offer many benefits including

• health
• dental
• vision
• PTO
• Extended Illness Leave
• Pension
• matching 401K

SUMMARY

responsible for managing and adjusting medical insurance claims under Personal Injury Protection and/or Medical Payments coverage. The PIP Claims Rep ensures timely and accurate processing of claims while maintaining compliance with regulatory requirements and company standards.

ESSENTIAL DUTIES AND RESPONSIBILITES

• Review, investigate, and process PIP and/or Medpay claims in accordance with applicable laws and policy provisions.
• Determine coverage eligibility, verify medical necessity, and assess reasonableness of charges.
• Communicate with claimants, medical providers, attorneys, etc. to gather necessary documentation to resolve claims.
• Maintain detailed and accurate claim files and documentation.
• Provide clear and empathetic communication to claimants and stakeholders.
• Address inquiries and resolve issues promptly and professionally.
• Prepare reports and summaries for management as needed.
• Regular and predictable attendance is required.

EDUCATION and/or EXPERIENCE

• H.S. Diploma is required
• Must obtain Adjuster's license in 6 months
• Customer service experience
• Familiarity with medical terminology & treatment protocols

Skills/Ability

• Proficient in English written and Verbal communication skills
• Possesses strong technical aptitude
• Proficient PC skills
• Good math skills
• Ability to type approximately 50wpm