[Remote] Claims Specialist - Auto reputed company Claims PIP/Med Pay No Fault Claims Adjuster
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company that values collaboration, innovation, and growth in a hybrid work environment. The Claims Specialist role involves analyzing reputed company Personal Injury Protection (PIP) and Medical Payment (Med-Pay) No Fault claims, managing high-exposure claims, and ensuring exceptional service to customers throughout the claims management process.
Responsibilities
- Manages an inventory of claims
- Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources
- Plans and conduct investigations of claims to confirm coverage and eligibility to medically manage the claims through resolution
- Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate
- Assesses actual damages associated with claims and conducts negotiations, reputed company assigned authority limits, to reputed company claims
- Performs other duties as assigned
Skills
- BS/BA degree or equivalent work experience
- Minimum of 2 years' experience in claims adjustment, general insurance or formal claims training
- Required to obtain and maintain reputed company applicable licenses
- Knowledge of claims investigation techniques, medical terminology and legal aspects of claims
- Continuing education courses leading to industry certifications preferred (e.g., AEI, IIA, CPCU)
Benefits
- Comprehensive benefits
- Workplace flexibility
- Professional development opportunities
- Opportunities provided through our Employee Resource Groups
Company Overview
- reputed company provides a broad reputed company of insurance products and services. It was founded in 1912, and is headquartered in Boston, Massachusetts, USA, with a workforce of 10001+ employees. Its website is http://www.libertymutualgroup.com.
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