PIP Adjuster

Company
American Modern Insurance Group
Location
Cincinnati , United States

American Modern Insurance Group has an exciting opportunity for an experienced PIP/Med pay Adjuster to join our Liability team!  

As a Personal Injury Protection and Medical Payments (PIP/MC) Claims Adjuster, you will be responsible for the investigation and resolution of non-litigated first party injury claims arising from PIP/MC coverage. This position will focus on the handling of first party injury claims arising from Collector Vehicle, Motorcycle, and Watercraft policies, and will entail determining coverage, ensuring accurate and timely processing, and ensuring compliance with all applicable regulatory and quality requirements. 

What You'll Do: 

• Handle claims that involve first party injury claims
• Establish contact with policyholders and injured parties
• Interpret coverage, conduct investigations, and interview necessary parties
• Work with bill review and medical management vendors as necessary
• Ensure timely and accurate claim processing
• Ensure necessary review and escalation of questionable/unreasonable claims 
• Handle telephone inquiries on claim status and coverage
• Complete appropriate oral, written, and on-line reports to reflect and supplement all file activity  
• Set and maintain adequate reserves on claim files
• Obtain and review reports, statements, records, and related materials as necessary
• Uses independent discretion/judgment and sound decision-making in the handling of claims
• Perform other duties as assigned

This position has a hybrid schedule, 40-50% of the time in the office in Amelia, OH and the remaining working from home.  Remote working arrangements will be considered for qualified candidates in other geographical locations.

 

Qualifications:

• Prior insurance industry experience and/or prior claims handling experience
• Prior Personal Injury Protection/Medical Payments claims handling experience is preferred
• Prior customer service experience requiring difficult/challenging conversations preferred
• Excellent verbal and written communication skills
• Planning, organization, and analytical skills are required
• Basic proficiency with Microsoft Word and Excel is needed
• Four year college degree or equivalent technical/professional education or work experience is required
• Industry related training or coursework such as AIC, CPCU, or SCLA are preferred     

Benefits that set us apart:

• Competitive compensation
• Comprehensive Medical Plans
• PTO and Family Leave
• 401K with an employer match and Retirement Savings Plans
• Dental and Vision Plans
• Life and Disability insurance
• Employee Assistance Program
• Adoption Assistance
• Wellness Programs - Calm, WW, SoFI, Virgin Pulse
• FSA and HSA Plans
• Hospital Indemnity, Critical Illness and Accident Plans
• Tuition assistance

 

At American Modern, a subsidiary of Munich Re, we see Diversity and Inclusion as a solution to the challenges and opportunities all around us. Our goal is to foster an inclusive culture and build a workforce that reflects the customers we serve and the communities in which we live and work. We strive to provide a workplace where all of our colleagues feel respected, valued and empowered to achieve their very best every day. We recruit and develop talent with a focus on providing our customers the most innovative products and services. 

 

We are an equal opportunity employer. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.