Personal Injury Protection (PIP) Claims Representative job Amherst New York
Personal Injury Protection (PIP) Claims Representative job Amherst New York
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Personal Injury Protection (PIP) Claims Representative Job



Employer Name: SpiderID: 7138138
Location: Amherst, New York Date Posted: 12/4/2017
Wage: Negotiable Category: Insurance
Job Code: 3022/2151

Job Description:

Primary Purpose:

Examine claims data, investigate the facts of loss, determine coverage and liability, and adjusts claims within limit of authority. Claims involved are usually subject to standardized procedures which lead to a settlement with limited exercise of discretion. Claims involved occasionally require analysis and may require research to resolve coverage and/or damage issues. There is supervisory review of ongoing progress and results of work. There is more focused supervision on all complex files.

Essential Duties and Responsibilities:

Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.



  • Responsible for investigating, evaluating, negotiating, and settling Personal Injury Protection (PIP) claims.

  • Responsibilities include but are not limited to: reviewing a person's injuries and loss of earnings claims after an accident; analysis of coverage and conducting investigation of injuries and causal relationship to claim; proactively interact with healthcare professionals to monitor treatment and disability and determine need for independent medical examinations; maintain cost containment practices regarding indemnity and expense payments on claims; negotiate claims with insured's, claimants, attorneys and providers; recognize and investigate recovery possibilities; comply with state regulatory requirements and maintain work according to individual/company goals; work in a team environment; other duties as assigned.

  • Ability to make prompt insured and claimant contact, investigate claims, analyze loss facts and coverages, and process claims payments timely.

  • Claims may involve multiple sub-limits of coverage; maintains current knowledge of changes in state.

  • May oversee files that use, but not limited to: medical management tools, such as case management, independent medical examinations and peer review; may oversee large loss, litigation and catastrophic losses.


Minimum Skills and Competencies:

The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.



  • Bachelors degree or equivalent business experience.

  • High school diploma or general education degree (GED) required

  • Knowledge of no-fault regulatory requirements for the state of New York (NY)

  • Currently possess or successfully secure NYS Workers' Comp & No Fault license upon hire

  • Ability to make prompt insured and claimant contact, investigate claims, analyze loss facts and coverages, and process claims payments timely.

  • Well-developed communication and organizational skills,

  • High degree of initiative and mature judgment, excellent customer service skills and the ability to resolve conflicts.

  • Microsoft Windows applications and general computer skills required.

  • Selected candidates will be required to successfully obtain/maintain appropriate licensing and/or educational requirements.

  • Has understanding of how to review, evaluate, and negotiate injury claims. Will demonstrate ability to handle more serious injuries.

  • Demonstrates a basic understanding of medical terminology and functions of the human body.

  • Demonstrates a basic understanding of anatomical terminology associated with injury claims, CPT and ICD coding.




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About National General Holdings:

National General Holdings Corp. is headquartered in New York City. National General traces its roots to 1939, has a financial strength rating of A- (excellent) from A.M. Best, and provides personal and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health, and other niche insurance products. We are a specialty personal lines insurance holding company. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.

National General is a fast paced, dynamic, and entrepreneurial organization. Our team members live by and exemplify what we call the 4Es. At National General, we are Energized, Engaged, Empowered, and we Execute every day in order to provide an exceptional experience for our customers! We are passionate about our organization and the value that we add every day. A successful candidate with National General will embody the 4Es. Our team is poised to outperform the competition. We are National General Insurance and with us you can be extraordinary! Come join our team!

Companies and Partners

Direct General Auto & Life, Personal Express Insurance, Century-National Insurance, ABC Insurance Agencies, NatGen Preferred, NatGen Premier, Seattle Specialty, National General Lender Services, ARS, RAC Insurance Partners, Mountain Valley Indemnity, New Jersey Skylands, Adirondack Insurance Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident.

In addition to a phenomenal career opportunity, National General Insurance offers an excellent benefits package including:

* Paid Training
* Medical, Dental, Vision benefits
* Wellness Programs
* Life and Short/Long Term Disability Insurance
* 401k w/ Company Match
* Company Paid Holidays & Generous Time-off policy
* Employee Discount Program
* Career Advancement and Development Opportunities
* On-site Healthcare Clinic (Winston-Salem and Cleveland offices)
* On-site Fitness Center (Cleveland and Dallas offices)
* Subsidized parking (Cleveland office)

National General Holdings Corp. is an Equal Opportunity (EO) employer - Veterans/Disabled and other protected categories. All qualified applicants will receive consideration for employment regardless of any characteristic protected by law. Candidates must possess authorization to work in the United States, as it is not our practice to sponsor individuals for work visas.

In the event you need assistance or accommodation in completing your online application, please contact NGIC main office by phone at (336) 435-2000.

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Job Criteria:
Start Date:
Position Type: Full-Time Permanent
Years of Experience Required:
Education Required:
Overnight Travel:
Vacation Time:


Contact Information:
Contact Name: National General Insurance Company Type:
Company: National General Insurance
City:
State:
Zip:

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