Senior PIP Adjuster, Texas Claims

This is a fully remote position, open to applicants in Texas.

📋 Description

• Investigate, assess, and modify PIP claims in line with Texas regulations and company policies.

• Gather essential information to thoroughly investigate and evaluate each case by liaising with brokers, insured parties, claimants, witnesses, and others.

• Examine medical records, billing information, and documentation to ascertain coverage, liability, and damages.

• Ensure adherence to Texas Department of Insurance regulations and statutory timelines.

• Manage intricate and litigated PIP claims, including disputes and arbitration processes.

• Communicate efficiently with claimants, attorneys, medical providers, and internal stakeholders.

• Review and negotiate medical bills and treatment plans for their reasonableness and necessity.

• Detect potential fraud indicators and escalate concerns as necessary.

• Maintain precise and timely documentation of claim files.

• Offer guidance and mentorship to junior adjusters as required.

• Oversee claim inventory to fulfill productivity and quality benchmarks.

⛳️ Requirements

• Over 5 years of experience in handling PIP claims, with a strong emphasis on Texas claims.

• Comprehensive understanding of Texas PIP statutes, fee schedules, and compliance obligations.

• Experience in managing complex, litigated, or high-exposure claims.

• Active Texas Adjuster License (mandatory).

• Strong analytical, negotiation, and decision-making capabilities.

• Exceptional written and verbal communication skills.

• Ability to handle a high-volume caseload in a dynamic environment.

• Proficient in claims management systems and Microsoft Office applications.

🏝️ Benefits

• Medical

• Dental

• Vision

• HSA*

• PTO

• 401k

• Company observed Holidays