Job Information
NJM Insurance PIP Rep I in Parsippany, New Jersey
"You work for NJM? That's a great company!" If you're hired at NJM, you'll hear it over and over again from friends, family and neighbors. Why? Because NJM is committed to providing its customers with superior service, and great service goes a long way. Why else is NJM called a great company? Because our employees enjoy working here, are appreciated, and are provided with a terrific benefits plan including 401K match up to 8%. Employees who are hired at NJM often stay at NJM – many for the duration of their careers.At NJM Insurance Group (NJM), a top-rated insurance company, NJM is looking for a Personal Injury Protection Representative who has excellent communication skills as well as strong organizational and time management skills. We are looking for talent with and without prior experience in the insurance industry.
Hours: Monday through Friday, 8:45 a.m. to 5:00 p.m. with work from home opportunities.
Salary: $48,642.10 - $56,460. annually. Salary is commensurate with experience and credentials.
PIP Claims Representative:
Review PIP coverages and/or identify coverage issues and investigate and analyze the loss event, the injury and other relevant information to make a determination as to coverage and course of action.
Evaluate claims for fraud indicators and potential underwriting issues and process appropriate referrals. Conduct activities in compliance with state and company regulations and guidelines
Render final coverage determination within regulatory guidelines: Maintain communication with involved parties during the course of the claim, via written and/or verbal communication, to provide relevant determinations and/or information.
Maintain communication with involved parties during the course of the claim, via written and/or verbal communication, to provide relevant determinations and/or information. Concisely and accurately document all actions taken throughout the course of the claim.
Manage all requests for medical treatment, durable medical equipment, PIP Care Paths, medical guidelines and policies, internal and/or external peer reviews and/or IMEs, when required, communicate determinations to appropriate parties within 3 business days.
Request necessary Independent Medical Examinations and render determinations for additional treatment or termination benefits.
Establish adequate medical and non-medical benefits reserves for the life of the claim and adjust reserves, if needed.
Calculate and issue non-medical benefits (wages, essential services, death benefits).
Demonstrates knowledge in NJ and in other states and is able to apply regulatory requirements appropriately.
Understands and applies all process and regulatory knowledge associated with arbitration and subrogation. Effectively utilizes all applications and manages time and responsibilities.
Position Requirements (Skills, Traits, & Experience)
Excellent verbal and written communication skills, knowledge of Microsoft suite
Strong interpersonal and customer service skills
Good organizational, time-management, and data entry skills
Decision-making and multi-tasking capabilities
Bachelor’s degree preferred
3-5 years of claims handling experience preferred
Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
What Makes NJM Different? The NJM team comprises talented people who do the right thing by our policyholders and each other. You’ll be part of a financially strong and stable company that has flourished on relationships, integrity, and service for more than a century. NJM is a special place where you can propel your career, help others, and make friends—all at the same time.
NJM is proud to offer our employees continuous learning options, outstanding benefits, access to wellness programs, and opportunities to give back to the communities we are privileged to serve.
We have been named a Forbes America’s Best-in-State Employer for five consecutive years.
Come join us! It’s time for you to make a difference on our remarkable team.