Job Description

NY No Fault / PIP Adjuster Automobile

• Experience in filing PIP Subrogation claims through Arb Forum / Intercompany arbitration.
• Candidate must possess strong persuasive writing skills and the ability to craft well-reasoned arguments to support subrogation demands and negotiate recoveries effectively.
• Supervise work product of subordinate adjusters on medical claims.
• Administer claims following NY No Fault law regulations and timelines.
• Duties of the candidate may include working directly with Attorneys, assignments and monitoring no fault litigation suits.
• Review of claim files information, such as claimants, medical providers and vendors to process data entry of claims, medical records, bill review, EOBs and denials, peer review, EUOs, vendor bills, review insurance claims, perform daily administrative functions.
• Direct tasks and activities of independent adjuster and other support services.
• Must maintain integrity of proprietary information.
• Investigates, evaluates, and advise on medical expense and Personal Injury Protection (PIP) claims as follows : review coverage determinations and advise as to the appropriate course of action
• Must be a true team player genuinely interested in working in a supportive, collaborative team environment
• Must be proficient in putting and identifying information that pertains to new claims timely and accurately
• Must be proficient in individual State PIP guidelines and requirements
• Must be able to identify coverage issues
• Must be diligent in identifying fraud or suspicious claims/activities Oversee local council (EUOs and litigated matters)
• Ability to understand medical reports and medical terminology
• Ability to understand legal concepts and legal terminology
• Exceptional organizational skills
• Demonstrate ability to work under tight deadlines
• Demonstrate ability to adapt to new and changing business needs

Requirements:

• Minimum of four years of experience in NY No fault claims.
• College degree preferred
• Strong analytical skills
• Excellent phone communication skills
• Computer skills with knowledge of Microsoft Word and intermediate Excel skills.

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