PIP Claims Specialist - Remote

AAA - CSAA Insurance Group; United States; Remote; USD 45,000 - 60,000; Full time

Job summary

A leading insurance group in the United States is seeking a PIP Specialist to manage moderately complex Personal Injury Protection claims. The role requires 1-2 years of experience in claims management and a relevant bachelor’s degree. Candidates should possess strong interpersonal skills and the capability to work remotely. Join a diverse team dedicated to supporting members in uncertain times, while contributing to a positive company culture.

Qualifications

• Minimum of 1-2 years of claims experience is required.
• Able to obtain and maintain multiple Adjuster’s Licenses within 90 days.
• Experience handling PIP claims and first-party medical coverage is preferred.

Responsibilities

• Handle moderately complex PIP and Medical Pay claims.
• Investigate, evaluate, and settle claims.
• Make coverage determinations and inform customers.
• Present coverage issues to the committee.

Skills

Claims handling

Medical coverage knowledge

Interpersonal skills

Computer navigation

Bilingual communication

Education

Bachelor's degree in business or related field

Job description

We, here at CSAA IG, are one of the top personal lines property and casualty insurance groups in the U.S. Our employees proudly live our core beliefs and fulfill our enduring purpose to help members prevent, prepare for and recover from life's uncertainties, and we're proud of the culture we create together.

Your Role:

As a PIP Specialist, you will handle to conclusion moderately complex claims involving first-party Personal Injury Protection (PIP) and Medical Pay claims. Cases are generally reserved up to $30,000.00. In cases where complexity of file increases beyond proficiency level, file is escalated to senior level for handling. Our team handles claims in multiple states and may assist with FNOL calls, Claims Advisory Support and Casualty Support as needed.

Your work:

• Assigned as the owning adjuster when injury exposure is identified for the first party, for files with reserves up to policy limits.
• Investigates, evaluates, and settles medical expense and Personal Injury Protection (PIP) claims.
• Makes coverage determinations and informs customers as to the appropriate course of action.
• Claims may involve additional suffixes such as income continuation and essential services.
• Investigates to rule out exposures: uninsured/underinsured motorist, subrogation, dram shop.
• Presents to committee on coverage issues.

Required Experience, Education and Skills:

• A minimum of 1-2 years of claims experience is required.
• Bachelor's degree in business, insurance, or related field OR equivalent combination of education and experience.
• Required to obtain and/or maintain multiple Adjuster’s License’s within the first 90 days of employment and/or job transfer if applicable.

What would make us excited about you:

• Prior experience handling PIP claims and first-party medical coverage is preferred.
• Knowledge or experience handling collision, loss-of-use, third-party property damage and bodily injury exposures preferred.
• Capability to complete training and perform the job in a remote setting as required.
• Flexibility to work any shift during the operating hours of 5:30 a.m. to 7 p.m. in your time zone, which may include evenings and/or weekends.
• Outstanding interpersonal skills and strong computer navigation abilities.
• Ability to handle several tasks simultaneously.
• Solid understanding of insurance coverages.
• Bilingual a plus!
• Shows respect for differences through excellent communication skills with people from an array of backgrounds.
• Actively shapes our company culture (e.g., participating in employee resource groups, volunteering, etc.)
• Lives into cultural norms (e.g., willing to have cameras when it matters: helping onboard new team members, building relationships, etc.)
• Fulfills business needs, which may include investing extra time, helping other teams, etc.

CSAA Insurance Group is an equal opportunity employer. We are committed to supporting inclusion and diversity at CSAA IG. We actively celebrate colleagues’ different abilities, sexual orientation, ethnicity, and gender. Everyone is welcome and supported in their development at all stages in their journey with us.