Jobless Developer

PIP Adjuster I

TampaRemoteFull-time

AI Summary

Investigates and adjusts PIP and Medpay claims of moderate complexity from start to resolution, managing coverage, medical bills, reserves, and fraud indicators.

About this role

Job Summary:

Investigate and adjust PIP claims of moderate complexity through their conclusion. The PIP adjuster will investigate coverage, medically manage files, pay medical bill as warranted and identify potential fraud indicators. This is inclusive of both PIP and Medpay claims.

Key Responsibilities

  • Complete initial and ongoing contact with insureds, medical providers and attorneys.

  • Obtain recorded statements as warranted.

  • Review and analyze policy language, case law and statutes and apply to claims handling.

  • Complete accurate coverage investigations to proper resolution.

  • Coordinate Independent Medical Examinations as warranted.

  • Establish proper reserves in accordance with company reserving guidelines.

  • Identify potential fraud indicators and work closely with Special Investigations Unit when appropriate.

  • Ability to work in a high volume, fast paced environment while maintaining accurate and detailed file handling.

Experience/Education:

  • Education: Bachelor’s Degree or equivalent work experience.

  • Experience: Minimum of 2 years handling non-standard insurance PIP claims.

  • Must have an active Florida Adjuster’s License

Skills

Case Law And Statutes ApplicationCoverage InvestigationFile HandlingFlorida Adjuster's LicenseFraud Indicator IdentificationIndependent Medical Examinations CoordinationMedical Bill ReviewMedpay ClaimsPIP Claims AdjustmentPolicy Language AnalysisRecorded StatementsReserving Guidelines

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