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[Remote] Claims Specialist - Auto reputed company Claims PIP/Med Pay No Fault Claims Adjuster

Remote Worldwide Hiring now

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 settle 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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