Commercial Auto Claims Rep - PIP (Temp to hire)

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.