Commercial Auto Claims Representative – PIP

🔥 14 hours ago

🇺🇸 United States – Remote

💵 $37 - $40 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 Ghost score 0%

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biBerk Business Insurance

WebsiteLinkedInAll Job Openings

51 - 200 employees

🛡️ Insurance

🤝 B2B

💸 Finance

Insurance • B2B • Finance

biBerk Business Insurance is a digital-first insurance provider focused on small business insurance, offering policies such as workers' compensation, professional liability (E&O), general liability, business owners policies (BOP), commercial auto, umbrella, and cyber coverage. Part of the Berkshire Hathaway Insurance Group and backed by A++ rated carriers, biBerk lets small businesses get online quotes, purchase policies, manage claims and documents, and access resources to simplify insurance. The company serves a wide range of small business industries (e. g. , restaurants, retail, contractors, IT, healthcare) and emphasizes instant coverage, cost savings, and direct-to-business underwriting.

📋 Description

• Investigate PIP and Medical Payments claims to verify coverage, eligibility, benefits, limits, deductibles, exclusions, and coordination-of-benefits requirements • Review policy language and apply state-specific PIP, no-fault, and MedPay statutes, regulations, fee schedules, and claims-handling deadlines • Obtain and evaluate accident information, medical records, itemized bills, treatment notes, wage documentation, and other claim materials • Review medical bills for coding, duplication, relatedness, reasonableness, necessity, and applicable fee-schedule or contractual adjustments • Evaluate and process covered medical expenses, wage-loss benefits, replacement services, and other PIP benefits • Maintain accurate benefit payment ledgers and monitor remaining limits, deductibles, offsets, and exhaustion of benefits • Communicate with insureds, claimants, medical providers, attorneys, billing representatives, and internal partners regarding claim status and benefit determinations • Escalate disputed treatment, suspected fraud, coverage concerns, potential overpayments, provider disputes, and matters requiring legal or supervisory review • Prepare requests for information, explanations of benefits, payment notices, and coverage or benefit decisions • Maintain timely diaries, organized claim files, payment rationale, and compliance with claim-handling guidelines and state requirements • Manage active claim inventory while meeting quality, timeliness, and customer-service expectations • Coordinate with bodily injury, liability, litigation, SIU, and vendor teams when warranted • Obtain and maintain required state adjuster licenses

🎯 Requirements

• 3+ years of auto claims experience, including hands-on PIP and/or Medical Payments claim handling • Multi-state PIP experience preferred • Working knowledge of no-fault/PIP and MedPay coverage, medical terminology, medical billing, benefit limits, fee schedules, and state-specific claim deadlines • Ability to interpret insurance policy language, review medical documentation, evaluate payable benefits, and explain decisions accurately • Excellent written and verbal communication skills, including professional letter writing and communication with providers and attorneys • Strong organizational, analytical, time-management, and computer skills, with the ability to prioritize and manage a busy pending • Self-motivated and capable of working independently in a remote office environment with appropriate supervision and escalation • Ability to adapt quickly to company claim systems, procedures, and changing priorities • Bachelor’s degree preferred; equivalent relevant claims experience considered • Insurance industry designation a plus • Ability to travel for company or claim-related events if needed • Obtaining and maintaining required state adjuster licenses

🏖️ Benefits

• Outstanding benefits • Competitive compensation • Remote office setting / fully remote work • Potential consideration for regular full-time employment based on business needs and individual performance • Ability to travel for company or claim-related events if needed

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