NJM Insurance Group
PIP Rep I
Parsippany, NJ
Aug 16, 2024
Full-time
Full Job Description

NJM Insurance Group (NJM), a top-rated insurance company, is looking for a Personal Injury Protection Representative who has excellent communication skills as well as strong organizational and time management skills. We are looking for talent with and without prior experience in the insurance industry.

Schedule: Monday through Friday, with work from home opportunities after training.

PIP Claims Representative:

Reporting to the immediate designated PIP Supervisor, the PIP claims representative is responsible and accountable for conducting complete and thorough investigation on assigned claims and medically managing those claims through their life cycle.

  • Review PIP coverages and/or identify coverage issues and investigate and analyze the loss event, the injury and other relevant information to make a determination as to coverage and course of action.

  • Evaluate claims for fraud indicators and potential underwriting issues and process appropriate referrals. Conduct activities in compliance with state and company regulations and guidelines

  • Render final coverage determination within regulatory guidelines: Maintain communication with involved parties during the course of the claim, via written and/or verbal communication, to provide relevant determinations and/or information.

  • Maintain communication with involved parties during the course of the claim, via written and/or verbal communication, to provide relevant determinations and/or information. Concisely and accurately document all actions taken throughout the course of the claim.

  • Manage all requests for medical treatment, durable medical equipment, PIP Care Paths, medical guidelines and policies, internal and/or external peer reviews and/or IMEs, when required, communicate determinations to appropriate parties within 3 business days.

  • Request necessary Independent Medical Examinations and render determinations for additional treatment or termination benefits.

  • Establish adequate medical and non-medical benefits reserves for the life of the claim and adjust reserves, if needed.

  • Calculate and issue non-medical benefits (wages, essential services, death benefits).

  • Demonstrates knowledge in NJ and in other states and is able to apply regulatory requirements appropriately.

  • Understands and applies all process and regulatory knowledge associated with arbitration and subrogation. Effectively utilizes all applications and manages time and responsibilities.

Position Requirements (Skills, Traits, & Experience)

  • Excellent verbal and written communication skills, knowledge of Microsoft suite

  • Strong interpersonal and customer service skills

  • Good organizational, time-management, and data entry skills

  • Decision-making and multi-tasking capabilities

  • Bachelor’s degree preferred

  • 3-5 years of claims handling experience preferred

Salary Range: $48,000 - $56,000 annually. Salary is commensurate with experience and credentials.

This role may be filled at a Level II or Senior level based on skills, experience and credentials.

Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.

PDN-9cc6cfe9-8d2a-4825-b31c-613d4d9019fd
Job Information
Job Category:
Insurance
Spotlight Employer
Related jobs
Apex Systems, Inc.
Technical Project Manager
Apex Systems, Inc.
Job#: 2053324 Job Description: Length of assignment 01-06-2025 to 07-11-2025Job DescriptionWe are Looking for a Lead Project Manager to join our team. You will be responsible for managing one or mor...
Nov 14, 2024
Brooklyn, OH
Apex Systems, Inc.
Job#: 2053334 Job Description: Job Title: Treasury Member Care SpecialistLocation: Charlotte, NC, Suffolk, VA, and Richmond, VA (100% onsite)Essential ResponsibilitiesAssist members with more advanc...
Nov 14, 2024
Suffolk, VA
Apex Systems, Inc.
Job#: 2053340 Job Description: Software Design EngineerEst. Duration: 7-months (potential to extend)Pay Range: 55-65/hr DoELocation: Remote (PST hours)A Fortune 50 Client in the Greater Seattle Area...
Nov 14, 2024
Redmond, WA
©2024 TalentAlly.
Powered by TalentAlly.
Apply for this job
PIP Rep I
NJM Insurance Group
Parsippany, NJ
Aug 16, 2024
Full-time
Your Information
First Name *
Last Name *
Email Address *
Zip Code *
Password *
Confirm Password *
Create your Profile from your Resume
By clicking the Apply button, you agree to the terms of use and privacy policy.
Continue to Apply

NJM Insurance Group would like you to finish the application on their website.