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CA
CURE Auto Insurance
PIP Claims Representative
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Based on New Jersey data
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What they do
A Claims Representative accepts and reviews applications for insurance and provides information to insurance agents. Assists insurance customers, answers questions and processes requests to change or cancel policies. May assist with insurance claims that are disputed, review claims and policy coverage and help to negotiate agreements between customers and an insurance company.
$59,708 / year median in New Jersey
+3% projected growth
Job Description
PIP Claims Representative CURE Auto Insurance is a leading direct writer of auto insurance in New Jersey, Pennsylvania, and Michigan. CURE offers a great working environment, competitive salary, and comprehensive benefits package which includes health and dental coverage, life and disability insurance, 401k with generous company match, and much more! The PIP Claims Representative will handle the investigation, evaluation and disposition by settlement, payment, or denial of complex Personal Injury Protection claims. Ensure that claims are processed within company policies, procedures, regulatory requirements, and the individual's prescribed authority with high standards of performance. Essential Job Functions Receive assigned claims, verify coverage, confirm eligibility and determine course of action. Complete detailed, thorough claim investigation through telephone and/or written correspondence with subscribers, attorneys, witnesses and any others with information relevant to the claim. Analyze information obtained through investigation in order to evaluate the claim, determine PIP eligibility and determine the extent of the injuries and claim exposure. Establish and maintain the proper reserves for the exposure. Assign medical case managers or other experts to a case when appropriate and arrange for independent medical examinations when necessary to determine medical necessity and causal relationship of treatment. Handle incoming calls and correspondence from subscribers, claimants, attorneys and providers regarding questions or problems associated with a claim. Document claim files and maintain a diary system for reporting and claim follow-up. Handle claims in accordance with CURE's Decision Point Review Plan. Work closely with the Special Investigation Unit, Underwriting Department, attorneys, and other members of the Claim Department to ensure that CURE achieves optimum results on all files. Manages allocated loss adjustment expense. Employs outside vendors when activities cannot be completed by a staff member and directs the activities of vendors to ensure only necessary work is completed Comply with all conditions outlined in the Unfair Claim Practices Acts. Perform other duties as assigned.