PIP Coverage and Qualification Adjuster

United Automobile Insurance Company is looking for a Coverage and Qualification Adjuster to join their team. The ideal candidate will have experience in Auto PIP Claims and an active adjuster's license in Florida or Texas. The role involves reviewing and processing Personal Injury Protection claims, ensuring compliance with company policies and state regulations.

Requirements

• Review and assess PIP claims to determine coverage eligibility
• Analyze medical records, police reports, and other relevant documents to evaluate the extent of injuries and to establish proof of loss
• Interpret insurance policies, contracts, and state regulations to determine the extent of coverage applicable to each claim
• Communicate with claimants, medical professionals, attorneys, and other parties involved in the claim process to gather necessary information and documentation
• Conduct interviews with claimants to gather necessary information that supports an objective final disposition of the claims
• Maintain accurate and organized claim files with all pertinent information, including correspondence, medical records, and assessment reports
• Issue payments for approved claims in accordance with company policies
• Ensure compliance with state laws, regulations, and company policies in all claim handling activities
• Generate and submit reports on claims activity, trends, and performance metrics
• Identify and investigate potentially fraudulent activities related to PIP claims
• Collaborate with the special investigation unit (SIU) when fraud is suspected
• Provide excellent customer service by addressing inquiries, concerns, and providing timely updates to claimants
• Prepare reports and documentation for internal purposes, regulatory compliance, and potential legal proceedings

Benefits

• 401(k) Retirement Savings Plan with employer match
• Comprehensive Medical, Prescription Drug, Vision, and Dental Insurance
• Paid Time Off, Holidays, and Leave programs
• Flexible spending accounts
• Basic Life Insurance and Voluntary Life/ADD
• Short Term and Long-Term Disability