Urgently Need NY PIP Adjuster - Remote in Florida
Posted 2025-03-15Job title: NY PIP Adjuster - Remote
Company: Allstate
Job description: The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good.
You'll do all this in an environment of excellence and the highest ethical standards - a place where values such as integrity, inclusive diversity and accountability are paramount. We empower every employee to lead, drive change and give back where they work and live. Our people are our greatest strength, and we work as one team in service of our customers and communities.
Everything we do at Allstate is driven by a shared purpose: to protect people from life's uncertainties so they can realize their hopes and dreams. For more than 89 years we've thrived by staying a step ahead of whatever's coming next - to give customers peace of mind no matter what changes they face. We acted with conviction to advocate for seat belts, air bags and graduated driving laws. We help give survivors of domestic violence a voice through financial empowerment. We've been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protection.
We are the Good Hands. We don't follow the trends. We set them.
Job Summary
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 a personal injury protection and/or medical payment benefits where the policy limits or exposure to the company is limited and occasionally when the policy limits or exposure to the company is moderate. 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 delivering compassionate service that is fast, fair, and easy, to ensure customer retention. At this level, the individual typically negotiates and settles moderately complex claims, such as claims in less regulated and occasionally moderately regulated states (or in some situations more complex claims with guidance as needed). The individual is capable of working independently, prioritizing the individual's own responsibilities, and managing the individual's own workload. The individual also consistently meets band level behaviors, production, quality, and/or customer service goals.
Key Responsibilities
Customer Service
- 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
- Researches and responds to moderately complex customer communications, concerns, conflicts, or issues
- File Documentation and Reporting
- Summarizes documents and enters claim system notes
- Documents a claim file with notes, evaluations, and decision-making process
- Processes medical bills and recognizes medical management opportunities
- 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 to determine 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 moderately complex coverage and other potential coverage; and investigates coverage denial questions
- Determines appropriate benefit and negotiates and settles moderately complex claims, including resolution of moderately complex usual and customary billings
- Monitors treatment and benefit payments for excessive, unreasonable, or abusive claims
- Handles specialized claims
- May participate in one or more moderately complex special assignments
- May serve as a committee team lead for smaller projects or as a committee team member on medium projects
- Reviews subpoenas and non-complex demands (e.g., Florida demands)
- May serve as an agent advocate
- May prepare and negotiate moderately complex subrogation issues or arbitrations
This position is a remote home-based role. Your home office does not need to be near an Allstate office, but it does need to be in the United States. This position is not available for California, Alaska, and Hawaii residents.
When you work from home full time, you'll need:
- a home office - a dedicated workspace in your residence that is private and free from distractions
- a minimum internet bandwidth of 50 MB down/5 MB up
- appropriate work surface and seating
- A technology bundle that includes all equipment needed to perform your work from home (laptop, monitors, headset, keyboard, mouse)
- Connectivity reimbursement of $80 per month to offset some of the cost of internet.
- High School Diploma/GED or higher
- Previous customer service experience in a fast paced, high volume work environment
- Previous experience handling personal injury/medical payment claims
To be successful in this role, a PIP Adjuster should possess the following skills:
- Strong knowledge of insurance policies, particularly personal injury protection coverage and relevant regulations
- Ability to evaluate claims by reviewing accident reports, medical records, and other documents
- Excellent communication skills for effectively interacting with claimants, medical providers, and other stakeholders
- Strong investigative and research skills to gather information and uncover relevant facts
- Analytical and critical thinking abilities to assess medical records, calculate reimbursement amounts, and make informed decisions
- Negotiation skills to resolve disputes, reach settlements, and establish payment plans
- Effective time management and organizational skills to handle multiple claims and meet deadlines
- Commitment to providing excellent customer service, showing empathy and professionalism
- Basic understanding of relevant laws and regulations related to insurance and personal injury cases
Allstate cares about you and your wellbeing. We offer a comprehensive total rewards package that includes pay, benefits, and programs to help you balance work with the rest of your life. You can choose whatever benefits are most important you. Here are some of our offerings:
- Competitive salary based on experience and qualifications
- Medical, dental, and vision coverage
- Allstate pension plan and 401(k) savings plan
- Ayco financial coaching
- Spring Health mental and emotional wellbeing resources
- Paid parental leave
- Adoption reimbursement
- Paid time off
- Tuition reimbursement
- Wellness incentives
- Allstate Foundation donation match and grant opportunities
Compensation offered for this role is $48,000.00-$66,400 per year and is based on experience and qualifications.
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 , , and or watch a .
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Allstate generally does not sponsor individuals for employment-based visas for this position.
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Expected salary: $48000 - 66400 per year
Location: Florida