Claims Associate Adjuster – PIP
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Job Description
PIP claims associate supporting adjusters with medical billing, documentation, payments, and claim processing. Amerisure serves commercial construction, manufacturing, and healthcare businesses.
Responsibilities:
- Provide quality assistance to adjusters throughout the claim lifecycle
- Respond to inquiries from policyholders, claimants, injured persons, medical providers and other stakeholders
- Gather and verify missing or incomplete information to support accurate claim processing
- Prepare and submit state filings, closing documents and administrative support requests
- Draft and distribute correspondence in accordance with company standards and regulatory requirements
- Enter data into the claims management system and maintain complete, accurate claim records
- Coordinate external vendors, including appraisers, attorneys and contractors
- Review and issue payments and invoices according to company policies and adjuster direction
- Provide medical providers with billing instructions, EOBs and payment information
- Explain coding and documentation denials and reconsideration processes
- Assist with reimbursement capture from the MCCA for claims exceeding retention
- Obtain HIPAA forms and order medical records for claim files
- Handle incoming calls and mail for the claims department
Requirements:
- Associate's degree or equivalent combination of education and experience
- Registered Health Information Technician (RHIT) preferred
- 1 year of experience in a healthcare setting, insurance or claims preferred
- Knowledge of medical terminology, HIPAA compliance, medical billing (EOBS, HICFA, CMS 1500 and small business forms) and coding practices required
- Ability to obtain appropriate state licensing as required
- Proficiency in Microsoft Office Suite, with an emphasis on Excel, required
- Familiarity with claims management software preferred
- Demonstrated ability to build positive relationships and partnerships within the department, across the organization and with external customers
- Excellent verbal and written communication skills
- Ability to organize and prioritize work to ensure timely deadlines
- Ability to critically think and independently investigate assigned tasks
- Ability to input data with a high accuracy rating and strong attention to detail
Benefits:
- Competitive base pay
- Performance-based incentive pay
- Comprehensive health and welfare benefits
- 401(k) savings plan with profit sharing
- Generous paid time off programs
- Flexible work arrangements
- Professional growth opportunities
- Collaborative and rewarding career environment
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