PIP Subrogation Claims Rep II

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.

West Trenton, New Jersey

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 below, please 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, or log in to check the status of your previous application.&nbsp;</h3> <h3><em><strong>&nbsp;</strong></em></h3> https://www.njm.com/about/careers

keywords: claims,reporting,claims,investigate,communication,medical,compliance,maintain,document,legal,analysis,production,organization,degree,communication

Full Time

Overview: At New Jersey Manufacturers (NJM), a top-rated insurance company, our General Claims department in West Trenton, NJ is looking for a PIP Subrogation Claims Representative who has excellent communication skills as well as strong organizational and time management skills. Reporting to the immediate designated Supervisor, the PIP subrogation claims representative is responsible and accountable for conducting complete and thorough investigation on assigned claims and managing those claims through their life cycle.
Responsibilities: <ul> <li>Reviews PIP coverages, investigate and analyze the loss event, and other relevant information to make a determination as to subrogation potentials and course of action</li> <li>Evaluates claims for fraud indicators and potential underwriting issues and process appropriate referrals.&nbsp; Conduct activities in compliance with state and company regulations and guidelines&nbsp;</li> <li>Maintains communication with involved parties during the course of the claim, via written and/or verbal communication, to provide relevant determinations and/or information</li> <li>Concisely and accurately document all actions taken throughout the course of the claim</li> <li>Manages all requests for medical supports, payment ledgers, PIP status and information to support the right of subrogation</li> <li>Demonstrates knowledge in all US states and is able to apply regulatory requirements and comparative negligence laws appropriately, as well as maintain the Statute of Limitations.</li> <li>Understands and applies all process and regulatory knowledge associated with arbitration and subrogation. Effectively utilizes all applications and manages time and responsibilities.&nbsp;</li> <li>Receives and processes PIP/MedPay Subrogation claims, seeking recoveries from adverse parties and/or their insurance carriers</li> <li>Thoroughly investigates and analyzes all PIP/MedPay Subrogation claims referred to the department, including the loss event and other relevant information to make appropriate decisions</li> <li>Conducts ongoing reviews independently and/or with supervisor of all assigned files, focusing on needed investigation for early resolution</li> <li>Professionally initiates contact with the adverse party, adverse carrier and attorneys to obtain relevant information regarding the loss</li> <li>Responds to requests for information and documentation via written and or verbal communication</li> <li>Negotiates claims and resolve liability and/or damage disputes for successful recoveries</li> <li>Accurately processes recovery checks and accurately process attorney payments</li> <li>Diary dates all open claims for review and close in a timely and accurate fashion</li> <li>Utilizes Claimcenter efficiently</li> <li>Coordinates efforts with the Subrogation Reps handling PD Subrogation on the same claim</li> <li>Makes Collection/Suit referrals to outside agencies/attorneys on claims that cannot be voluntarily resolved and coordinate efforts until conclusion of the claim&nbsp;&nbsp;&nbsp;&nbsp;</li> <li>Prepares claims for Arbitration where applicable, to include writing effective contentions, filing online, monitoring the Respondent&rsquo;s answer and reviewing the decisions&nbsp;</li> </ul>
Requirements: <ul> <li>Excellent verbal and written communication skills, knowledge of Microsoft Office</li> <li>Ability to produce quality work in a timely fashion</li> <li>Strong interpersonal, negotiation and customer service skills</li> <li>Good organizational, time-management, and data entry skills</li> <li>Must be detail oriented, with good decision-making and multi-tasking capabilities</li> <li>Bachelor&rsquo;s degree or minimum of 2-4 years of PIP claims handling experience preferred</li> </ul>