Commercial Auto Claims Representative
Job Description
Commercial Auto Claims Representative (PIP) – Temp to Hire Job Summary Seeking a highly skilled and experienced Commercial Auto Claims Representative (PIP) to join a team on a temporary-to-hire basis. This fully remote position offers an exciting opportunity to work with a reputable organization known for its strong commitment to service, innovation, and integrity. The ideal candidate will have a proven track record in handling commercial auto claims, particularly Personal Injury Protection (PIP) and Medical Payments (MedPay), with multi-state experience being a significant advantage.
Compensation
Package Hourly Rate: $37 - $41 per hour Employment Type: Temporary to Hire Remote Work: 100% remote
Responsibilities
As a Commercial Auto Claims Representative (PIP), your primary responsibilities will include: - Investigating and managing assigned commercial auto first-party medical benefit claims - Verifying applicable coverage, eligibility, benefits, limits, deductibles, exclusions, and coordination-of-benefits requirements - Reviewing policy language and applying state-specific PIP, no-fault, and MedPay statutes, regulations, and fee schedules - Evaluating accident information, medical records, itemized bills, treatment notes, and wage documentation to determine benefit eligibility and payment - Reviewing medical bills for coding accuracy, duplication, relatedness, reasonableness, and necessity - Processing covered medical expenses, wage-loss benefits, and other PIP benefits in compliance with policy terms and applicable laws - Maintaining accurate benefit payment ledgers and monitoring remaining limits, deductibles, and offsets - Communicating professionally with insureds, claimants, medical providers, attorneys, and internal partners regarding claim status and benefit determinations - Recognizing and escalating disputed treatments, suspected fraud, coverage concerns, and other issues requiring legal or supervisory review - Preparing timely and accurate correspondence, including requests for information, explanations of benefits, and coverage decisions - Managing an active claim inventory efficiently while meeting quality, timeliness, and customer-service expectations - Coordinating with bodily injury, liability, litigation, SIU, and vendor teams as necessary - Obtaining and maintaining required state adjuster licenses Qualifications/Requirements We are looking for candidates who meet the following criteria: - Experience: Minimum of 3+ years of auto claims experience, including hands-on PIP and/or MedPay claim handling. Multi-state PIP experience is preferred - Knowledge: Strong understanding of no-fault/PIP and MedPay coverage, medical terminology, medical billing, benefit limits, fee schedules, and state-specific claim deadlines - Skills: Ability to interpret insurance policy language and evaluate medical documentation - Excellent written and verbal communication skills, including professional correspondence with providers and attorneys - Strong organizational, analytical, and time-management skills - Proficiency in computer systems and the ability to adapt quickly to new claim systems and procedures - Education: Bachelor’s degree required. Equivalent relevant claims experience may be considered - Insurance industry designations are a plus - Licensing: Must have a home state adjuster license and the ability to obtain Texas and Florida licenses (costs covered by the company) - Additional Requirements: Familiarity with salvage platforms and total loss claims is preferred - Cargo claims experience is a plus - Ability to travel for company or claim-related events if needed #LI-BC1