PIP Litigation Adjuster - Farmington Hills, MI
The world isnt standing still, and neither is Allstate. Were moving quickly, looking across our businesses and brands and taking bold steps to better serve customers evolving needs. Thats why now is an exciting time to join our team. Youll have opportunities to take risks, challenge the status quo and shape the future for the greater good.
Youll do all this in an environment of excellence and the highest ethical standards a place where values such as integrity, inclusive diversity and accountability are paramount. We empower every employee to lead, drive change and give back where they work and live. Our people are our greatest strength, and we work as one team in service of our customers and communities.
Everything we do at Allstate is driven by a shared purpose: to protect people from lifes uncertainties so they can realize their hopes and dreams. For more than 89 years weve thrived by staying a step ahead of whatevers coming next to give customers peace of mind no matter what changes they face. We acted with conviction to advocate for seat belts, air bags and graduated driving laws. We help give survivors of domestic violence a voice through financial empowerment. Weve been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protection. We are the Good Hands. We dont follow the trends. We set them.Job Description
Allstate Insurance Company has an exceptional career opportunity for an Inside PIP Adjuster in (city), (state)!
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
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
Bachelors degree in related field preferred or equivalent experience plus two years experience delivering outstanding customer service preferred.
Prior claims or insurance experience preferred
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
- Generous Paid Time Off
- Medical, Dental, and Vision coverage
- Company-matched 401(k) and company-funded pension
- A culture of learning where you can expect to develop foundational skills for the future
- Opportunities for both personal and professional development
- Leadership teams that are communicative and engaged
- Impactful work by serving customers and the community in times of need
- Recognition and advancement opportunities
- Learn more about Allstate benefits @ https://allstategoodlife.com
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.For a full description of Allstates benefits, visit allstate.jobs/benefits/
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.
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