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Experienced PIP Adjuster

Employer
Allstate Insurance Company
Location
Farmington Hills, Michigan
Salary
Not Specified
Closing date
Feb 21, 2019

View more

Category
Claims
Job Type
Not Specified
Career Level
Not Specified

Job Details

Where good people build rewarding careers.

Think that working in the insurance field cant be exciting, rewarding and challenging? Think again. Youll help us reinvent protection and retirement to improve customers lives. Well help you make an impact with our training and mentoring offerings. Here, youll have the opportunity to expand and apply your skills in ways you never thought possible. And youll have fun doing it. Join a company of individuals with hopes, plans and passions, all using and developing our talents for good, at work and in life.

Competencies

Customer Focus

Decision Making

Adaptability

Planning and Organizing

Communication

Job Description

Allstate Insurance Company has an exceptional career opportunity for an Inside PIP Adjuster (Medical Specialty Unit) in Farmington Hills, MI!

About the Team
The Claims Department is here to restore peoples lives after the unexpected has happened. We work to deliver compassionate service that is fast, fair and easy. Putting our customers first to resolve their claim and taking the stress out of the situation is our goal.

This is your chance to help make a meaningful difference in peoples lives. Join the thousands of people who work in the claims industry in highly stimulating work that will require you to assimilate data, evaluate facts and negotiate solutions to complex problems. Every day presents different learning and growth opportunities. You will gain a broad range of professional skills that will be equally applicable and highly valuable no matter where your career takes you.

About the Position
Under general supervision, this job is responsible for handling the medical portion of auto accident claims for the insured or other injured parties found to be eligible under a personal injury protection and/or medical payment benefits where the policy limits or exposure to the company is limited and occasionally when the policy limits or exposure to the company is moderate. This individual determines coverage and assesses medical claims, evaluates medical bills, and initiates or reviews potential fraud investigations as warranted. At this level, the individual typically negotiates and settles moderately complex claims, such as claims in less regulated and occasionally moderately regulated states (or in some situations more complex claims with guidance as needed).

Specific responsibilities include
Customer Service

Researches and responds to moderately complex customer communications, concerns, conflicts or issues


File Documentation and Reporting
Documents a claim file with notes, evaluations and decision making process
Processes medical bills and recognizes medical management opportunities


Medical Management (1st Party)
Assesses medical/physical condition and prior injuries of claimant, and obtains and analyzes 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, and to ensure compliance with fee schedules, and detect duplicate billing
Conducts first party file processing/fact gathering, including interviewing claimant, witnesses, medical providers, etc.
Evaluates medical records and treatment plan of claimant and determines if continued treatment is reasonable
Investigates, reviews, and accepts or rejects moderately complex coverage and other potential coverage; and investigates coverage denial questions
Determines appropriate benefit and negotiates and settles moderately complex claims, including resolution of moderately complex usual and customary billings
Monitors treatment and benefit payments for excessive, unreasonable, or abusive claims
Handles specialized claims
Other Projects and Responsibilities
May serve as a committee team lead for smaller projects or as a committee team member on medium projects
Reviews subpoenas and non-complex demands (e.g., Florida demands)
May serve as an agent advocate
May prepare and negotiate moderately complex subrogation issues or arbitrations

Job Qualifications

Ideal Qualifications

High School/GED &/or Bachelors degree in related field preferred or equivalent experience
3-5 years prior PIP claims handling experience is strongly preferred
Ability to investigate, evaluate, negotiate and settle moderate and occasionally complex claims
Excellent written and verbal communication skills with a passion for helping others.
Strong organizational and computer skills.
Persistence and the ability to work through and solve problems.
Bilingual candidates are strongly encouraged to apply
Has and maintains all appropriate licenses and registrations for the role per state requirements

The candidate(s) offered this position will be required to submit to a background investigation, which includes a drug screen.

Good Work. Good Life. Good Hands.


As a Fortune 100 company and industry leader, we provide a competitive salary but thats just the beginning. Our Total Rewards package also offers benefits like tuition assistance, medical and dental insurance, as well as a robust pension and 401(k). Plus, youll have access to a wide variety of programs to help you balance your work and personal life -- including a generous paid time off policy.


Learn more about life at Allstate. Connect with us on Twitter, Facebook, Instagram and LinkedIn or watch a video.


Allstate generally does not sponsor individuals for employment-based visas for this position.

Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.

For jobs in San Francisco, please click "here" for information regarding the San Francisco Fair Chance Ordinance.

For jobs in Los Angeles, please click "here" for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance.

It is the policy of Allstate to employ the best qualified individuals available for all jobs without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity/gender expression, disability, and citizenship status as a veteran with a disability or veteran of the Vietnam Era.

Company

COMPANY INFORMATION The Allstate Corporation (NYSE: ALL) protects people from life's uncertainties with more than 113 million proprietary policies. Allstate offers a broad array of protection products through multiple brands and diverse distribution channels, including auto, home, life and other insurance offered through its Allstate, Esurance, Encompass, SquareTrade and Answer Financial brands. Allstate is widely known from the slogan "You're in Good Hands with Allstate." The Allstate Corporation is the largest publicly held personal lines property and casualty insurer in America. Allstate was founded in 1931 and became a publicly traded company in 1993. In 2023, Allstate was number 84 on the Fortune 500 list of largest companies in America. WHAT WE DO We’re more than insurance agents and claims representatives. We’re individuals with hopes, plans and passions. The biggest of which is helping people live smarter, safer lives. Doing so means continuing to re-imagine how we do what we do, the impact we can make on the world, ways we can each succeed in our own careers and actions we can take as a company that are good for all. To do that, we need all kinds of people – including lawyers, accountants, building engineers, project managers, marketing professionals, human resource specialists and so many more. WHO WE ARE – INCLUSIVE DIVERSITY    We hold each other accountable to encourage and embrace our collective differences. It’s our individual characteristics, values and beliefs, along with backgrounds and experiences that give us fresh perspective and purpose. We work harder, meet customer needs more effectively, share better, and identify more innovative ideas when we are accepted for who we are by the world around us. Our success comes from a chorus of many different voices. At Allstate, every voice counts.​ In our stand against racism, we’ve been making changes within Allstate. We’ve been listening, learning and engaging in change. We are focused on improving equity for all. Allstate is committed to long-term change not only in the way we conduct our business, but also for our employees. There’s a dynamic environment waiting for you here. You’ll find people with similar interests, as well as the many who’ll help expand your horizons. We believe in the power of connections. That’s why Allstate promotes diversity through a robust network of employee resource groups. It helps connect us all and supports our unique talents. Here are some of the available resource groups that actively support our employees: Abilities Beyond Limitations & Expectations African American Working Network Allstate Asian American Network Allstate Foster and Adoption Network Allstate PRIDE Allstate Veterans Engagement Team and Supporters Allstate Women’s Information Network Entrepreneurs at Allstate Families at Allstate Matter Native American Peoples at Allstate Professional Latino Allstate Network Young Professionals Organization WHY JOIN OUR COMPANY Allstate has been protecting people from life's uncertainties since 1931. We continuously develop and improve products and services so our customers can live well protected. For employees, we offer an environment that fosters innovative thinking and collaboration - where you'll be able to explore your ideas and feel proud of the work you do.  Our Benefits Allstate is dedicated to helping employees live happier and healthier lives. As a Fortune 100 company and industry leader, we provide a competitive salary and a benefits package that includes medical and dental insurance, tuition assistance, as well as a robust pension and 401(k). Plus, you'll have access to a wide variety of programs to help you balance your work and personal life - including a generous paid time off policy.  Growth and Development We support your desire to grow and provide opportunities to learn, explore new horizons, and follow your passion in a meaningful career. From access to hundreds of learning opportunities to in-house networking and rotational work experiences, Allstate is a place where you can forge your own path and expand your personal and professional potential. 
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