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PIP Adjuster 3

PIP Adjuster 3

Job ID 

More information about this job


Provides customer service, administers, and examines policy coverage for complex injury and fraud claim settlement determinations within authority level.

Job Responsibilities:

  • Handles complex cases (e.g. material misrepresentation, fatality losses according to state specific guidelines, and impact losses with injury claims).
  • Answers questions from insureds, claimants, and attorneys to resolve problems and concerns.
  • Reviews policy coverage and documents/processes complex personal injury protection claims. Uses claims systems to locate prior losses and to maintain claim information.
  • Documents all conversations and recorded statements with involved parties, including correspondence, bills and actions.
  • Documents files and pays submitted bills according to procedures.
  • Sends necessary correspondence and completes actions to satisfy department of insurance and/or state specific regulations.
  • Addresses diaries, correspondence, emails, and voicemail timely.
  • Submits required reports to underwriting regarding claims issues.
  • Opens reserves appropriate to reflect exposure to the policy.
  • Identifies bodily injury and un-insured motorist claims and reassigns to appropriate department.
  • Handles arbitration responses and assists litigation in handling of demands.
  • Refers files to special investigation unit and assists with direction to the investigation.

  • Detail-oriented with strong organizational skills, able to work well under deadlines in a changing environment and perform multiple tasks effectively and concurrently.
  • Demonstrated ability to work effectively under pressure and within a collaborative team oriented environment using sound judgment in decision-making.
  • Excellent communication skills both oral and written with strong analytical skills.
  • Excellent customer service and negotiation skills
  • Demonstrated proficiency with Microsoft Office products (Excel, PowerPoint, and Word) and insurance software applications.
  • Demonstrated knowledge of different bodily injury and/or loss claims.
  • Must be able to travel 10%

    Experience / Education:
  • Bachelor?s degree in related field or equivalent education preferred.
  • Four years of personal injury protection claims handling experience with one year arbitration and/or litigation required.

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