Claims Associate Adjuster - PIP; REMOTE

Amerisure creates exceptional value for its partners, policyholders, and employees. As a property and casualty insurance company, Amerisure’s promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee. With an A.M. Best “A” (Excellent) rating, Amerisure serves mid-sized commercial enterprises focused in construction, manufacturing and healthcare.

Ranked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus. Amerisure is currently recruiting for a Claims Adjuster Associate – PIP role. Knowledge of medical terminology, HIPAA compliance, medical billing (EOBS, HICFA, CMS 1500 and small business forms) and coding practices required.

Candidates who live near one of our office locations will have the expectation of working in an office 2 days a week (Tuesday and Wednesday). Candidates who do not live near an office will have a remote work arrangement, with the expectation of coming into an office as business needs arise. The ideal candidate will also possess the following skill set.

The PIP Claims Associate provides quality assistance to adjusters at all phases of the claim lifecycle to drive the claim to timely conclusion. Supports the success of the organization through interactions with agencies, policyholders, and employees. This individual will handle incoming calls and mail for the claims department and facilitate tasks and processes to aid the adjuster to process claims accurately and efficiently.

• Respond to inquiries from policyholders, claimants, injured persons, medical providers and other stakeholders regarding claim status, receipt of payment or medical bills, and other claim-related questions.
• Obtain and verify information by gathering missing or incomplete details from relevant parties, including policyholders, claimants, witnesses, and external vendors, to support accurate claim processing.
• Assist with claim documentation by preparing and submitting required state filings, closing documents, and other administrative support requests on behalf of adjusters.
• Draft and distribute correspondence to policyholders, claimants, injured persons, medical providers or agents in accordance with company standards and regulatory requirements.
• Maintain accurate claim records by entering data into the claims management system and ensuring all documentation is complete and up to date.
• Coordinate external vendors by engaging appraisers, attorneys, and contractors, to support the claims process.
• Process payments and invoices by reviewing and issuing payments in accordance with company policies and adjuster direction.
• Provide information and billing instructions to medical providers including gathering EOBs, and payment information. Explain coding and documentation denials including the process for reconsiderations.
• Assist with the capture of reimbursement from the MCCA for claims that have breached retention.
• Obtain HIPPA forms from injured persons and order medical records for the claim file.

• Associate's degree or equivalent combination of education and experience. Registered Health Information Technician (RHIT) preferred.
• 1 year of experience in a healthcare setting, insurance or claims preferred.
• Knowledge of medical terminology, HIPAA compliance, medical billing (EOBS, HICFA, CMS 1500 and small business forms) and coding practices required.
• Ability to obtain appropriate state licensing as required.
• Proficiency in Microsoft Office Suite with an emphasis on Excel required.
• Familiarity…