PIP Claims Representative- Gainesville, FL

PIP Claims Representative

This job is with Florida Farm Bureau which is the Florida state office for Southern Farm Bureau Casualty Insurance Company, and we currently have an opening for a PIP Claims Representative to work in Gainesville, FL. This position is responsible for managing and adjusting medical insurance claims under Personal Injury Protection and/or Medical Payments coverage. In this role you will ensure timely and accurate processing of claims while maintaining compliance with regulatory requirements and company standards.

Starting salary of $40,500. We offer many benefits including health, dental, vision, PTO, Extended Illness Leave, Pension and matching 401K.

SUMMARY:

Responsible for managing and adjusting medical insurance claims under Personal Injury Protection and/or Medical Payments coverage. The PIP Claims Rep ensures timely and accurate processing of claims while maintaining compliance with regulatory requirements and company standards.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Include the following. Other duties may be assigned.

• Review, investigate, and process PIP and/or Medpay claims in accordance with applicable laws and policy provisions.
• Determine coverage eligibility, verify medical necessity, and assess reasonableness of charges.
• Communicate with claimants, medical providers, attorneys, etc. to gather necessary documentation to resolve claims.
• Maintain detailed and accurate claim files and documentation.
• Provide clear and empathetic communication to claimants and stakeholders.
• Address inquiries and resolve issues promptly and professionally.
• Prepare reports and summaries for management as needed.
• Regular and predictable attendance is required.

EDUCATION AND/OR

EXPERIENCE:

• H.S. Diploma is required
• Must obtain Adjuster's license in 6 months
• Customer service experience
• Familiarity with medical terminology & treatment protocols

SKILLS/ABILITY

• Proficient in English written and Verbal communication skills
• Possesses strong technical aptitude
• Proficient PC skills
• Good math skills
• Ability to type approximately 50wpm

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.