Claims Adjuster - PIP
Job Opportunity at Independent Insurance Staffing Services

Posted on Jan 5

http://www.iistaffing.com    214-236-3464

Location: Independence, OH
Job Type: Full Time
Job ID: W4149475


Claims Adjuster - PIP
Independence, OH

Evaluate auto claims involving injured parties and manage first party medical treatment to determine eligibility under a personal injury protection and/or medical payment benefits.

Daily Responsibilities:
•             Review claims to determine the nature of the medical loss and provides explanation of coverage.
•             Research policy contract and interpret policy language to make coverage decisions based on 1st party medical coverages.
•             Assess medical treatment, evaluate medical bills, and initiate or review potential fraud investigations.
•             Interpret medical records regarding injuries and address ongoing and continuous treatment for claimant.
•             Identify claim exposure and establish reserves or adjust reserves accordingly on assigned files.
•             Ensure claim files are properly documented and correctly coded based on the policy.
•             Document all claim activity and workflow accurately throughout the life of the claim in accordance with standard operating procedures.
•             Provide effective and timely communication to client, claimants, medical providers, attorney offices, and vendors.
•             Negotiates resolution of claims and make payments within authority.

For confidential consideration - send resume to Toni at TLWashington@iistaffing.com.
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