Medical Manager
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Job Description
First Party Medical Manager leading PIP claims adjusters at an insurtech company revolutionizing car insurance with technology. Ensuring compliance and training for best practices with a focus on personal injury claims.
Responsibilities:
- Leads a team of PIP/MPC Claims Adjusters who are responsible for the handling of first-party medical claims.
- Help train and educate leaders and adjusters on New Jersey PIP claim handling best practices.
- Ensures adherence to state regulations and applicable policy language.
- Oversees adjuster review of medical bills and works with vendor(s) to properly handle 1st party injury claims.
- Reviews and approves payments over adjuster authority.
- Acts as a coach to promote understanding of MOI, causation and medical management.
- Create and execute talent development strategies for claims personnel, while recognizing the outsized impact that people have on the performance of the organization.
- Measure, evaluate and communicate individual and team performance results in relation to overall organizational objectives.
- Drive pace in a scalable manner, resulting in best-in-class LAE while maintaining high employee and customer satisfaction.
- Interacts and communicates effectively with claims leadership, business partners, and teammates.
- Understand and leverage analytics, process automation, and technology to improve efficiency and quality within claims operations.
- Drive process innovation with a high degree of discernment between true differentiators and superficial features.
- Engages in learning opportunities to build knowledge of personal lines claims, court decisions impacting the claims function, current guidelines in claims function, and policy changes and modifications.
- Recruits, retains and develops a highly motivated and accountable team of experienced and developing claim liability professionals.
Requirements:
- New Jersey PIP adjusting and leadership experience (three years minimum)
- Insurance licenses or professional insurance designations preferred
- Strong understanding and application of laws, statutes, and regulations specific to PIP/MPC handling
- Ability to coach to and drive medical management
- Ability to interpret insurance policy language and apply coverage correctly to claim decisions
- High sense of professionalism while remaining empathetic
- Familiarity with claims best practices required
- Great attention to detail
- Self-starter and ability to work independently and effectively prioritize work
- Ability to handle ambiguity and quickly adapt when changes occur
- Strong written and oral communication skills
- Ability to obtain and maintain insurance licenses in several states (including Texas) within three months of start date.
Benefits:
- Health insurance
- Flexible work arrangements
- Professional development
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