PIP Claims Rep II

<strong>Personal, compassionate service is what we're known for at NJM. We seek the best and brightest to help our customers when they need us most. As part of the NJM team, you'll not only enjoy some of the best benefits in the industry, you'll also be joining a company that's committed to professional development, diversity and innovative thinking.</strong>

Parsippany, NJ

NJM Insurance Group

<p><strong>Come Grow with Us!</strong></p> <p>&nbsp;</p> <p>For more than a century, our policyholders have trusted us to serve them in their times of need. For just as long, we have supported our employees by providing a competitive compensation package and opportunities for growth. If you are looking to be part of something special and make a difference each day, we invite you to come grow with us. There's never been a better time to join the NJM family.&nbsp;</p> <h3>This isn't just insurance.&nbsp;&nbsp;<strong>It's NJM</strong><strong>.<br /><br /><br /></strong>If you don't see the job you're looking for, click <a href="https://chu.tbe.taleo.net/chu02/ats/careers/v2/searchResults?org=NJM3&amp;cws=47" target="_blank" rel="noopener noreferrer">here</a> to create a search agent!<em><strong><br /></strong></em></h3> https://www.njm.com/

keywords: medical,claims,analysis,medical,management,compliance,investigate,organization,degree,experience


Overview: Our Parsippany Medical Services Administration Department is in search of a detail oriented PIP Claims Representative to prepare complete and thorough investigations on assigned claims and manage those claims through their life cycle.&nbsp; This exciting opportunity is great for the experienced claims professional who is a highly organized, results-oriented, curious and diverse thinker who thrives in a fast-paced organization focused on superior customer service, business process improvement, and growth.
Responsibilities: <ul> <li>Verify coverage and initiate contact with policyholders, injured parties, medical providers and attorneys.</li> <li>Maintain communication with involved parties during the course of the claim.</li> <li>Investigate and analyze the loss event, the injury and other relevant information to make a determination as to coverage and course of action.</li> <li>Manage the claim, which includes: establishing adequate reserves, monitoring medical treatment, issuing expense and non-medical benefit payments, and evaluating appropriateness of ongoing treatment.</li> <li>Evaluate the claim for potential fraud.</li> <li>Document all actions taken throughout the course of the claim.</li> <li>Conduct activities in compliance with State and company regulations and guidelines.</li> <li>Evaluate the claim for closure.</li> </ul>
Requirements: <ul> <li>3-5 years of claims handling experience required</li> <li>Claims experience in multiple states a plus</li> <li>Excellent verbal and written communication skills</li> <li>Strong interpersonal and customer service skills</li> <li>Good organizational, time-management and data entry skills</li> <li>Decision making and multi-tasking capabilities</li> <li>Bachelor&rsquo;s degree preferred</li> </ul>