PIP Claims Representative- Gainesville, FL

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 RESPONSIBILITES: 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