First Party Medical Claims Adjuster

Job Summary

A company is seeking a PIP/MED PAY First Responder to join their team, focusing on investigating and resolving First Party Medical claims in multiple states, ensuring adherence to company guidelines and state regulations.

Key Responsibilities

• Conduct thorough investigations of First Party Medical Claims, including taking recorded statements and obtaining necessary documents
• Resolve First Party Medical Claims by sending recommendations for approval or denial based on Policy Language and state regulations
• Review and respond to correspondence and medical bills in accordance with State Regulations and company guidelines

Required Qualifications and Education

• High School Diploma or Equivalent; Bachelor's degree preferred
• Must have or be able to obtain a valid Adjuster License in the State of Texas or Florida and any other assigned state
• One or more years of experience in Auto Insurance as a Claims Adjuster required
• Experience with 1st Party Medical Claims preferred
• Bilingual (Spanish and English) is preferred