Experienced NY Personal Injury Protection (PIP) Adjuster - Remote Claims Handling and Medical Management Specialist

Join the Allstate Team as a Remote NY PIP Adjuster and Help People Protect Their Hopes and Dreams

Allstate is a leading Fortune 100 company and industry leader in the insurance sector, with a rich history spanning over 89 years. We're driven by a shared purpose: to protect people from life's uncertainties so they can realize their hopes and dreams. Our company culture is built on values such as integrity, inclusive diversity, and accountability, and we empower every employee to lead, drive change, and give back to their communities. As a remote NY PIP Adjuster, you'll play a critical role in handling medical portions of auto accident claims, determining coverage, assessing medical claims, and delivering compassionate service to our customers.

About the Role

We're seeking an experienced NY Personal Injury Protection (PIP) Adjuster to join our team as a remote claims handling and medical management specialist. As a PIP Adjuster, you'll be responsible for handling the medical portion of auto accident claims for insured or other injured parties found to be eligible under personal injury protection and/or medical payment benefits. You'll work independently, prioritizing your responsibilities and managing your workload, while consistently meeting band level behaviors, production, quality, and customer service goals.

Key Responsibilities:

• Customer Service: Make and maintain connections with customers, understanding and meeting their needs, serving with empathy, and following up to ensure customer needs have been met.
• Research and Response: Research and respond to moderately complex customer communications, concerns, conflicts, or issues.
• File Documentation and Reporting: Summarize documents and enter claim system notes, document a claim file with notes, evaluations, and decision-making process, and process medical bills.
• Medical Management: Assess medical/physical condition and prior injuries of claimant, obtain and analyze medical bills, wage loss reviews, home service or attendant care, mileage payments, and other related claims to determine reasonableness of charges and relation of injuries to accident.
• Coverage and Claims Handling: Investigate, review, and accept or reject moderately complex coverage and other potential coverage; investigate coverage denial questions, determine appropriate benefit, and negotiate and settle moderately complex claims.
• Specialized Claims: Handle specialized claims, monitor treatment and benefit payments for excessive, unreasonable, or abusive claims.
• Other Projects and Responsibilities: Participate in moderately complex special assignments, serve as a committee team lead for smaller projects or as a committee team member on medium projects, review subpoenas and non-complex demands, and prepare and negotiate moderately complex subrogation issues or arbitrations.

Requirements and Qualifications

Essential Qualifications:

• Education: High School Diploma/GED or higher.
• Experience: Previous customer service experience in a fast-paced, high-volume work environment, and previous experience handling personal injury/medical payment claims.
• Functional Skills: Strong knowledge of insurance policies, particularly personal injury protection coverage and relevant regulations; ability to evaluate claims by reviewing accident reports, medical records, and other documents; excellent communication skills; strong investigative and research skills; analytical and critical thinking abilities; negotiation skills; effective time management and organizational skills; commitment to providing excellent customer service.

Preferred Qualifications:

• Insurance Industry Experience: Experience working in the insurance industry, particularly in claims handling or medical management.
• Certifications: Relevant certifications, such as CPCU or ARM.

What We Offer

Compensation and Benefits:

• Competitive Salary: $48,000 - $66,400 per year, based on experience and qualifications.
• Comprehensive Benefits: Medical, dental, and vision coverage, Allstate pension plan and 401(k) savings plan, Ayco financial coaching, Spring Health mental and emotional wellbeing resources.
• Perks: Paid parental leave, adoption reimbursement, paid time off, tuition reimbursement, wellness incentives, Allstate Foundation donation match and grant opportunities.

Work Environment and Culture:

• Remote Work: Work from home full-time, with a dedicated workspace and minimum internet bandwidth of 50 MB down/5 MB up.
• Company Culture: Collaborative, dynamic, and supportive culture, with opportunities for growth and development.

How to Apply

If you're a motivated and experienced claims handling professional looking for a new challenge, we encourage you to apply for this exciting opportunity as a remote NY PIP Adjuster. Please submit your application, including your resume and cover letter, to join our team and help people protect their hopes and dreams.

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