Personal Litigation Injury Protection Resolution Specialist

Requirements

• Provide prompt, courteous and high-quality customer service to all policyholders and claimants by answering customer calls, filing claims, and resolving customer requests
• Investigate PIP / MP claims to determine coverage, extent of injury and evaluate medical billing for necessity and relatedness to the claim
• Gather relevant documentation, interview involved parties, explain policy, coverage, and appropriate course of action and resolve related medical expenses
• Assess the validity of PIP claims based on collected evidence, medical records, and applicable laws
• Manage an inventory of claims, establish initial reserves for all potential exposures, and adjust as appropriate throughout the claim
• Ensure compliance with specific state regulations, policy provisions, and standard operating procedures
• Maintain regular communication with claimants, policyholders, attorneys, medical providers, and other relevant parties to provide updates on claim status, request additional information, and facilitate the claims process within approved payment authority
• Prepare thorough and accurate claim reports, including detailed summaries of investigation findings, evaluation of damages, and rationale for claim decisions
• Provide input for continuous development of claims guidelines, best practices, and process improvements
• Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to resolve the claim
• Engage in learning opportunities to build knowledge of commercial lines claims, court decisions impacting the claims function, current guidelines in claims function, and policy changes and modifications

Benefits

• Generous health-insurance package with nationwide coverage, vision, & dental
• 401(k) retirement plan with employer matching
• Competitive PTO policy
• Generous family leave policy
• Work from anywhere to facilitate your work life balance
• Apple laptop, large second monitor, and other quality-of-life equipment