Remote PIP & Med Pay Claims Specialist (NJ)

Sedgwick; Trenton (NJ); Remote; USD 75,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Full benefits package (medical, dental

vision, 401k on day one

Job summary

Sedgwick is seeking a Claims Examiner for PIP/Med Pay in New Jersey with strong NJ claims experience. The role requires handling moderately to highly complex claims, inputting data accurately, and guiding insureds through the process while maintaining high service levels.

The ideal candidate has 6 years of related experience, including 3 years in PIP/Med Pay, and holds or will secure the necessary state licenses. Sedgwick offers a comprehensive benefits package and a supportive work environment.

Qualifications

• Six years of related experience, including three years of PIP/Med Pay adjusting.
• Bachelor's degree preferred.
• Secure and maintain State adjusting licenses as required for the position.

Responsibilities

• Investigates, negotiates, and resolves PIP/Med Pay claims per policy provisions and jurisdictional requirements.
• Input claim data and guide insureds through the claims process.
• Document thought process, investigation, evaluation, negotiation, and settlement decisions.
• Prioritize workload to keep policyholders informed with timely status updates.
• Serve as a subject matter expert on state laws, regulations, and procedures for claims handling.
• Deliver best-in-class claim service through proactive communications with customers and brokers.
• Work independently within limits on high-technical complexity assignments.
• Identify suspicious claims.
• Take recorded statements.
• Identify, confirm, and decide on coverage for complex claims.

Skills

PIP/Med Pay adjusting

Claims handling

Negotiation

State licensing

Education

Bachelor's degree

Professional certification

Job description

Sedgwick is seeking a Claims Examiner for PIP/Med Pay in New Jersey with strong NJ claims experience. The role requires handling moderately to highly complex claims, inputting data accurately, and guiding insureds through the process while maintaining high service levels.

The ideal candidate has 6 years of related experience, including 3 years in PIP/Med Pay, and holds or will secure the necessary state licenses. Sedgwick offers a comprehensive benefits package and a supportive work environment.