Commercial Auto Claims Representative (PIP) - TEMP

Description

This is a temporary contract assignment. While permanent employment is not guaranteed, successful contractors may be considered for regular full-time employment based on business needs and individual performance. The Commercial Auto PIP & Medical Payments Adjuster will be responsible for investigating, evaluating, and resolving first-party Personal Injury Protection (PIP) and Medical Payments (MedPay/MP) claims. This temporary position requires sound knowledge of applicable policy provisions, state-specific benefits and payment requirements, medical bill review, and timely claim administration.

Berkshire Hathaway biBerk offers a collaborative company culture with outstanding benefits and competitive compensation. Our success is founded on our strong reputation, and we have received an A+ “Superior” grade by the leading independent insurance rating organization. Backed by our ultimate parent company, Berkshire Hathaway Inc., our brand is founded upon trust, service, and innovation. If you’re looking for an employer with integrity and flexibility, keep reading to learn about our benefits and job openings.

Job Responsibilities

• •The PIP & Medical Payments Adjuster is responsible for managing assigned commercial automobile first-party medical benefit claims from a remote office setting. The Adjuster is also responsible for, but not limited to:
• •Investigating PIP and Medical Payments claims to verify 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, fee schedules, and claims-handling deadlines.
• •Obtaining and evaluating accident information, medical records, itemized bills, treatment notes, wage documentation, and other materials necessary to determine benefit eligibility and payment.
• •Reviewing medical bills for coding, duplication, relatedness, reasonableness, necessity, and applicable fee-schedule or contractual adjustments; referring matters for specialized review when warranted.
• •Evaluating and processing covered medical expenses, wage-loss benefits, replacement services, and other PIP benefits when provided by the policy and applicable law.
• •Maintaining accurate benefit payment ledgers and monitoring remaining limits, deductibles, offsets, and exhaustion of benefits.
• •Communicating clearly and professionally with insureds, claimants, medical providers, attorneys, billing representatives, and internal partners regarding claim status, documentation, and benefit determinations.
• •Recognizing and escalating disputed treatment, suspected fraud, coverage concerns, potential overpayments, provider disputes, and issues requiring legal or supervisory review.
• •Preparing timely, accurate correspondence, including requests for information, explanations of benefits, payment notices, and coverage or benefit decisions within assigned authority.
• •Maintaining timely diaries, organized claim files, clear payment rationale, and compliance with company claim-handling guidelines and applicable state requirements.
• •Managing an active claim inventory efficiently while meeting established quality, timeliness, and customer-service expectations.
• •Coordinating with bodily injury, liability, litigation, SIU, and vendor teams when claim circumstances warrant.
• •Obtaining and maintaining required state adjuster licenses.

Requirements

Qualifications

We are seeking candidates with the following:

• •3+ years of auto claims experience, including hands-on PIP and/or Medical Payments claim handling; multi-state PIP experience preferred.
• •Working knowledge of no-fault/PIP and MedPay coverage, medical terminology, medical billing, benefit limits, fee schedules, and state-specific claim deadlines.
• •Ability to interpret insurance policy language, review medical documentation, evaluate payable benefits, and explain decisions accurately.
• •Excellent written and verbal communication skills, including professional letter writing and communication with providers and attorneys.
• •Strong organizational, analytical, time-management, and computer skills, with the ability to prioritize and manage a busy pending.
• •Self-motivated and capable of working independently in a remote office environment with appropriate supervision and escalation.
• •Ability to adapt quickly to company claim systems, procedures, and changing priorities.
• •Bachelor’s degree preferred; equivalent relevant claims experience considered. Insurance industry designation a plus.
• •Ability to travel for company or claim-related events if needed.

About Us

biBerk is where commercial insurance buyers can obtain coverage for their businesses from insurers of the Berkshire Hathaway group of Insurance Companies, one of the best capitalized insurance groups in the world. Our ultimate parent, Berkshire Hathaway Inc. (berkshirehathaway.com) is a holding company with diversified interests in a host of industries, including insurance, energy, transportation and manufacturing. Most policies issued through biBerk.com will be underwritten by Berkshire Hathaway Direct Insurance Company (“BHDIC”), which is an AM Best rated A++ insurer.

BHDIC is domiciled in Omaha, Nebraska. BHDIC and the team at biBerk are focused on helping small business owners quickly and easily buy affordable insurance directly from a financially strong insurance company they can trust.