42 pip claims representative jobs found

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, this specific role could have the flexibility to work from home up to 3 days per week. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our team as an experienced PIP Claims Representative. The position requires the following but is not limited to: Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, and pay benefits that are owed. Review medical bills, authorize payments and ensure payments are issued in a timely and accurate manner in accordance with the Michigan No Fault Statute. Work toward the resolution of claims, and attend arbitrations, mediations,...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, this specific role could have the flexibility to work from home up to 3 days per week. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our team as an entry level PIP Claims Representative in MI PIP Claims. The position requires the person to: Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, and pay benefits that are owed. Review medical bills, authorize payments and ensure payments are issued in a timely and accurate manner in accordance with the Michigan No-Fault Statute. Administer benefits payable under the Michigan No-Fault Statute, Work toward the...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our team. This job handles insurance claims under close supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job includes training and development completion of the Company’s claims training program for the assigned line of insurance and requires the person to: Investigate, evaluate, and...

NJM Insurance Group (NJM), a top-rated insurance company, is looking for a Personal Injury Protection Representative who has excellent communication skills as well as strong organizational and time management skills.  We are looking for talent with and without prior experience in the insurance industry. Schedule: Monday through Friday, with work from home opportunities after training.  PIP Claims Representative: Reporting to the immediate designated PIP Supervisor, the PIP claims representative is responsible and accountable for conducting complete and thorough investigation on assigned claims and medically managing those claims through their life cycle. Review PIP coverages and/or identify coverage issues and investigate and analyze the loss event, the injury and other relevant information to make a determination as to coverage and course of action. Evaluate claims for fraud indicators and potential underwriting issues and process appropriate referrals....

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Senior Casualty Litigation Specialist – The Auto Club Group What you will do: (Primary Duties & Responsibilities) The Auto Club Group is seeking a prospective  Senior   Claim Specialist  to work under less supervision with a high-level of authority. In this position, you will have the opportunity to: Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   Complete coverage analysis on the most complex claims. Ensure all possible policyholder benefits are identified.  Create additional sub-claims if needed.  Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should...

Our West Trenton General Claims Legal Department is seeking a motivated, detail-oriented individual for a PIP Litigation Assistant role. Reporting to the designated supervisor and accountable for efficiently collecting and organizing pertinent information of appeal, litigation/arbitration process for adjusters and defense counsel. Hours:  Monday to Friday 8AM- 5PM (Hours can vary based on NJM start time) Salary: $40,500- $47,080 (Salary is commensurate with experience and credentials)   Job Responsibilities Receive, analyze, and process complaints/arbitration demands, create litigation matters, and assign to appropriate PAL adjuster for review. Assist PAL Adjusters and supervisors by accurately entering pertinent information into Claim Center, OnBase, and Agile Point.   Review the investigation file material, select appropriate information, and electronically send to defense firms Provide support to PAL Adjusters with document requests and information needed...

Description About Reserv Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike. We have ambitious (but attainable!) goals and need adjusters who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can’t wait to meet you.     About the role We are seeking highly organized and customer-focused Resolution Specialists to join our team. The successful candidate will be responsible for communicating with customers on the phone, educating and...

Reporting directly to the Medical Management Supervisor and indirectly to the Medical Management Administrator and Medical Services, the Precert Coordinator supports our Workers Compensation and Auto (PIP/Medpay) lines of business by performing prospective and retrospective Utilization Review of medical services/treatment requested or rendered by medical providers/suppliers to ensure compliance with regulatory guidelines, where appropriate, and to ensure services are clinically supported based upon NJM Medical Policies, standard professional treatment and/or evidence-based guidelines.      Job Responsibilities: Accurately and effectively evaluate the claim history and current medical records against NJM medical policies and evidence-based guidelines in order to determine whether treatment is clinically appropriate and causally related.   Evaluate requests for precertification/preauthorization/prescreen to determine if treatment is medically necessary, clinically...

NJM's SIU department in West Trenton, NJ is seeking a Summer Intern for 2025. Job Responsibilities: Triaging and analyzing scorecards and outputs from predictive models for General Claims, Personal Lines, Personal Injury Protection (PIP) claims and Medical Providers. Conduct data mining efforts to explore anomalies, conduct statistical analysis, and identify patterns and trends related to fraudulent Personal Lines and Commercial Lines policies and claims. Conduct background research on available public databases to support the need for the escalation of the claim review.  Review NJM databases, retrieve NJM recorded calls, and support the investigative teams. Provide metrics and statistics, as well as actionable intelligence to aid in decision making. Articulate and convey analyses into information that can be consumed by non-technical staff. Share analytical findings with SIU Supervisory staff.  Attend virtual industry meetings to broaden exposure to the insurance...

There’s never been a better time to join NJM!  With a nationally ranked reputation for outstanding customer service and a history that spans more than a century, NJM is a leading provider of worker’s compensation, automobile and homeowners insurance in New Jersey. Become a member of our team and you’ll be part of a company who operates for the sole benefit of its policyholders and is committed to maintaining the highest levels of service.  Team members are offered a competitive compensation package and benefits including: a 401k plan, health coverage, a generous paid time off plan, and much more! Our West Trenton MSA (Medical Services Administration) Medical Bill Processing Department has an opening for a Bill Processor and is seeking a candidate who has excellent communication skills as well as strong organizational and time management skills. Schedule: Monday-Friday, specific hours are subject to selected start times between 8:00am-9:00am pending supervisory approval....

Claims Representative, Subrogation   About Us:   Join our thriving team in the historic city of Boston, where innovation and service excellence meet. The Plymouth Rock Company, headquartered in the heart of Boston, manages over $2.0 billion in personal and commercial auto and homeowner’s insurance, earning an unparalleled reputation for service. If you're ready to take on a challenging role in a vibrant city known for its rich history and forward-thinking culture, this opportunity is for you.   Role Overview: As a Claims Representative, Subrogation, you'll be a vital part of our mission to recover funds from parties responsible for losses sustained by our insureds. Join our dynamic team and contribute to maximizing recoveries through effective claims presentation and negotiation.   Essential Functions and Responsibilities: Dive into automobile liability cases, identifying all liable parties in the unique Boston market. Initiate...

Claims Representative, Subrogation   About Us:   Join our thriving team in the historic city of Boston, where innovation and service excellence meet. The Plymouth Rock Company, headquartered in the heart of Boston, manages over $2.0 billion in personal and commercial auto and homeowner’s insurance, earning an unparalleled reputation for service. If you're ready to take on a challenging role in a vibrant city known for its rich history and forward-thinking culture, this opportunity is for you.   Role Overview: As a Claims Representative, Subrogation, you'll be a vital part of our mission to recover funds from parties responsible for losses sustained by our insureds. Join our dynamic team and contribute to maximizing recoveries through effective claims presentation and negotiation.   Essential Functions and Responsibilities: Dive into automobile liability cases, identifying all liable parties in the unique Boston market. Initiate...

NJM’s General Claims Legal Department is currently seeking to fill a PIP Appeals and Litigation (PAL) Representative position. We are looking for talent who has excellent communication skills as well as strong organizational and time management skills. This is a full-time position and offers a hybrid schedule after training.  The PAL Representative will conduct a complete and thorough investigation on assigned PIP Payment Appeal and Litigation claims and manage those claims through their life cycle. It is an exciting and challenging opportunity for anyone who is willing to learn and grow while further developing their PIP knowledge. Essential Duties and Responsibilities: • Review, evaluate and process incoming Pre-Litigation Appeals in accordance with the PIP Internal Appeal Procedures • Review, manage and update litigated files to maximize litigation resources and ensure legal outcomes consistent with NJM litigation strategy • Evaluate and process all claims,...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Claim Specialist  Michigan PIP – The Auto Club Group What you will do:  ***This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.*** Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling...

NJM is considering 2025 summer interns for our Special Investigations Unit, (SIU). Interns for the summer season will assist the SIU in anti-fraud efforts by conducting data analysis, intelligence gathering, and leveraging internal and external data sources to support SIU’s policy and claim investigations. The SIU Intern will gain work experience while performing meaningful tasks and projects. This summer internship is part of a structured program that will provide challenging work assignments/projects, an overall view of the business, and networking opportunities. Job Responsibilities: Triaging and analyzing scorecards and outputs from predictive models for General Claims, Personal Lines, Personal Injury Protection (PIP) claims and Medical Providers. Conduct data mining efforts to explore anomalies, conduct statistical analysis, and identify patterns and trends related to fraudulent Personal Lines and Commercial Lines policies and claims. Conduct background...

Foundation Risk Partners , one of the fastest growing insurance brokerage and consulting firms in the US, is adding a Customer Service Advocate to their Corporate Synergies team in Philly  Metro Region.  Job Summary: The Benefits VIP Representative attends to claims resolution issues, benefits questions, eligibility of coverage concerns, etc. for the administrators and employees of our clients. They collaborate over the phone with clients and carriers to arrive at resolutions within a 24 hour time frame.      Essential Functions: Resolve client employee insurance issues, handle questions regarding benefits and assists in claims processing issues. Also assists with patient advocacy and pre-certifications.    Educate client employees on proper benefit  utilization and guidance on most cost effective plan usage.     Develops and updates all applicable required documents for plan provisions, administrative...

Primary Details Time Type: Full time Worker Type: Employee The Opportunity: The purpose of this role is to manage the delivery of programs and projects by leading project teams, ensuring effective stakeholder management and business engagement, serving as the primary point of contact for project status and budget reporting and facilitating strong partnerships with third-party contributors to manage project schedules, risks and issues. Location: Sun Prairie, WI -  GBR, London (30 Fenchurch Street ) Work Arrangement: This role is hybrid, where you will be expected to be in the office 2-3 days per week   The salary range for this role is between $108,000-$203,000 Your new role Monitor project performance metrics to ensure delivery of accurate analysis in alignment with project schedules, timelines, budget resources, and achievement of desired business outcomes. Manage budget and planning process for relevant project/s or program/s....

Guided by our company Purpose of “Inspiring well-being for our colleagues, consumers, and communities,” we are committed to building a best-in-class Law Department. We drive a high-performance culture across our Legal, Compliance, and Government Affairs functions, aligned to “what” we deliver (i.e., our goals and objectives) and “how” we demonstrate our values and behaviors while focusing on the customer. We do this through leveraging a series of core capabilities, which includes accountability, interpersonal effectiveness, ability to demonstrate business savvy, being a subject matter expert, all while supporting the Law Department’s Mission to be a trusted advocate and advisor to drive strategic solutions that advance Guardian’s purpose, priorities, and values. Do you want to be part of a collaborative fast-paced Data Strategy & Security team as a Data Strategy & Security Compliance Lead? This newly created role provides a unique opportunity to collaborate with a...

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs.   Join us and play your part in something special! What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! As a Sales &...

This role can be Hybrid or Remote in Southern CA THE OPPORTUNITY: HUB’s Customer Service professionals provide critical support to our customers through account management, claims management, day-to-day client oversight, and underwriting services that make us a leading sales and service organization in the insurance industry. Through a robust network of resources, you will be amongst some of the industry’s top talent to help guide and support our customer’s needs and provide them with innovative solutions. The Employee Benefits Account Representative II works collaboratively with the Producer and Account Team managing a book of business. Coordinates and provides day-to-day service for employee benefits clients by maintaining client relationships, supporting client retention, maintaining strong carrier relationships and understanding client needs. Serves as day to day contact and provides resolution for client questions and issues. The Employee Benefits Account...