Allstate PIP Adjuster in Farmington Hills, Michigan
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Job ID :
Farmington Hills, MI US
Entry Level Professional
Job Category :
Where good people build rewarding careers.
Think that working in the insurance field can’t be exciting, rewarding and challenging? Think again. You’ll help us reinvent protection and retirement to improve customers’ lives. We’ll help you make an impact with our training and mentoring offerings. Here, you’ll have the opportunity to expand and apply your skills in ways you never thought possible. And you’ll 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.
Allstate Insurance Company has an exceptional career opportunity for an Entry Level Inside PIP Adjuster 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 people’s 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 personal injury protection and/or medical payment benefits where the policy limits or exposure to the company is limited. This individual determines coverage and assesses medical claims, evaluates medical bills and initiates or reviews potential fraud investigations as warranted. The individual explains coverage, negotiates and settles claims and follows up with the customer on continuing treatments while gaining experience in delivering compassionate service that is fast, fair, and easy, to ensure customer retention. At this level, the individual typically settles minor or smaller claims, such as claims in less regulated states (or on some occassions more complex claims with guidance as needed).
Specific responsibilities include
• Makes and maintains a connection with the customer by understanding and meeting their needs; serves the customer with empathy; and follows up to ensure that customer needs have been met
File Documentation and Reporting
• Summarizes documents and enters into claim system notes
• 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 in determining 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
• Sets up IME and reviews results
• Investigates, reviews and accepts or rejects coverage and other potential coverage
• Determines appropriate benefit and settles basic claims, including resolution of basic usual and customary billings
• Monitors treatment and benefit payments for excessive, unreasonable, or abusive claims
Please note, there is a required 1-week training that will take place in Wheeling, IL.
• Bachelors degree in related field preferred or equivalent experience plus two years’ experience delivering outstanding customer service and any medical billing/claims 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
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 that’s 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, 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.
Learn more about life at Allstate. Connect with us on Twitter at http://jb.al.st/BWGk6 , Facebook at http://jb.al.st/BWGka , Instagram at http://jb.al.st/BWGlO and LinkedIn at https://www.linkedin.com/company/allstate/careers or watch a video at http://jb.al.st/BWGpG .
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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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.