PIP Claims Specialist: Investigate & Resolve Medical Claims

Florida Farm Bureau General Insurance Company; Gainesville (FL); Hybrid; USD 36,000 - 54,000; Full time

Job summary

Florida Farm Bureau General Insurance Company in Gainesville is seeking a Personal Injury Protection (PIP) Claims Representative to manage and adjust medical insurance claims under PIP and Medpay coverage. The role requires reviewing and processing claims, determining coverage, and communicating with claimants and providers.

Ideal candidates will have a high school diploma, be willing to obtain an adjuster license within 6 months, and possess strong customer service, English communication, and

Qualifications

• High school diploma required; adjuster license within 6 months.
• Customer service experience helpful.
• Familiarity with medical terminology and treatment protocols beneficial.

Responsibilities

• Review, investigate, and process PIP/Medpay claims per laws and policy.
• Determine coverage, medical necessity, and reasonableness of charges.
• Communicate with claimants, providers, and attorneys to gather docs.
• Maintain detailed, accurate claim files and documentation.
• Provide clear, 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 required.

Skills

Customer service experience

Familiarity with medical terminology

English communication skills

Technical aptitude

PC skills

Math skills

Education

High school diploma

Adjuster license within 6 months

Job description

Florida Farm Bureau General Insurance Company in Gainesville is seeking a Personal Injury Protection (PIP) Claims Representative to manage and adjust medical insurance claims under PIP and Medpay coverage. The role requires reviewing and processing claims, determining coverage, and communicating with claimants and providers.

Ideal candidates will have a high school diploma, be willing to obtain an adjuster license within 6 months, and possess strong customer service, English communication, and