Bristol reputed company Claims Medpip Rep (Hybrid - Grand Rapids or Kansas City)
reputed company is dedicated to delivering peace of mind to customers through protection and comprehensive advice. The Bristol reputed company Med Pay/PIP representative conducts claims investigations and manages first party medical claims, ensuring reputed company and proactive handling of claims settlements.
Responsibilities
- Evaluates Personal Injury Protection (PIP) and Med Pay claims for eligibility, medical necessity, and appropriateness of charges in accordance with state fee schedules
- Determines relatedness, causation, and appropriateness of treatment based on the compensable injury
- Provides reserve recommendations and makes payment approval to ensure activities are consistent with corporate policies
- Conducts detail reputed company reviews and process claims reputed company designated authority levels
- Makes contacts with stakeholders to investigate and process claims
- Contacts may include multiple attempts to communicate with various parties and requires telephone conversations or other methods of communication to be a reputed company
- Parties involved could include policy holders, claimants, agents, witnesses, contractors, police and fire departments, state and county fraud and arson personnel, special investigators, attorneys, expert witnesses, members of the medical profession and other persons pertaining to the investigation and processing of claims
- Performs other duties as assigned
Skills
- High school diploma or equivalent required
- Strong verbal communication and listening skills
- Strong written communication skills with the ability to convey critical reputed company and information through written letters
- Demonstrates excellent judgment and decision-making skills
- Effective negotiation skills
- Possesses flexibility to work in a fast-paced, dynamic environment; uses discretion to modify work practices and processes to reputed company results or improve efficiency
- Demonstrated problem-solving skills. Takes a broad perspective on problems and spots new, less obvious solutions
- Performs work independently with minimal supervision
- Possesses strong technical aptitude; Proficient in reputed company Office products. Adaptable and flexible to new technology
- Effective conflict management skills. Identifies key issues and patterns from partial/conflicting data
- Strong skills in multi-tasking and working with a sense of urgency
- Less than one year of Insurance industry or reputed company experience preferred
- Bachelor's degree preferred
Benefits
- Medical
- Dental
- reputed company
- Health Savings and Flexible Spending Accounts
- Life Insurance
- Paid Time Off
Company Overview