Kentucky Farm Bureau Mutual Ins Co

  • Claim Representative - PIP Unit

    Job Locations US-KY-Louisville
    Posted Date 2 weeks ago(9/28/2018 3:05 PM)
    Job ID
    2018-1235
    # of Openings
    1
    Category
    Claims
  • Overview

    .

    The Claim Representative-PIP Unit handles no-fault claims from all claim offices within the state of Kentucky to ensure efficient and effective processing of Personal Injury Protection (PIP) benefits.

    Responsibilities

     

    ESSENTIAL FUNCTIONS

    • Accept assignment of PIP claims from claim adjusters.
    • Monitor continuing eligibility of PIP claimants.
    • Receive, investigate, coordinate, and pay appropriate PIP benefits in timely manner according to statute requirements.
    • Maintain proper reserves.
    • Process incoming and outgoing mail in regards to PIP Unit.
    • Create and type correspondence and issue form letters to investigate, resolve and responds to questions relating to PIP benefits.
    • Receive telephone and personal inquiries relating to PIP files by policyholders, customers, attorneys and medical providers, providing assistance where appropriate or referring to other staff if necessary.
    • Assure high customer satisfaction levels through professionalism, integrity, fairness and promptness.
    • Assist and cooperate with all company personnel.
    • Maintain PIP files to comply with statute requirements.
    • Monitor the claim inventory report to ensure proper closure of files.
    • Pursue professional development.
    • Report claims as required by claims manual or by district claims manager.
    • Serve as a catastrophe team member or assist in other claim offices or locations as required.
    • Regular, predictable attendance as employee has to physically be in the office.
    • This list of essential functions is non-exhaustive and may be supplemented as necessary.

     

    OTHER RESPONSIBILITIES

    • .Establish companion PIP work file.
    • Secure appropriate PIP documents, i.e., medical reports, wage verifications, PIP applications. 
    • Obtain initial claim payment authority on each claimant from claim adjusters.
    • Diary all companion claim files to comply with statute requirements.
    • Furnish copy of PIP application, medical reports and wage verification to claim adjusters as requested.
    • Receive, investigate and pay medical bills, wage loss benefits, survivor's economic benefits, replacement service benefits and funeral expense benefits.
    • Maintain appropriate reserves for both basic and added reparation benefits.
    • Perform claim file maintenance transactions via terminal entry.
    • Receive and review loss reports on a regular basis from agents, claim adjusters and senior adjusters.
    • Establish claim files using data from loss reports.
    • Type letters and forms required to properly investigate and document payment of no             fault benefits.
    • Transmit recoveries to the Accounting Department on a timely basis.
    • Report claims as required by Claim Manual or by District Claims Manager.
    • Promptly respond to complaints as requested.
    • Report immediately the receipt of all summonses to PIP Unit Supervisor and handle as directed.
    • Review claim inventory reports monthly and make needed adjustments.
    • Make corrections on claim files as recommended by PIP Unit Supervisor or Team Lead following review.
    • Document claim files to support actions taken. (See claim manual)
    • May be called upon to handle first party claims and non-disputed liability claims.
    • May be called upon to assist on evaluation of inventory sheets for property loss claims.
    • Attend and participate in company meetings, seminars and other company sponsored educational activities at the request of the company.
    • May work a late Friday on a rotating basis to provide customer service to claims offices, agents and providers.
    • Attain the Certificate in General Insurance from Insurance Institute of America.
    • Maintain current knowledge of policy contracts and statute.

     

    JOB SPECIFICATIONS

    • Physical demands: Normal vision/hearing with or without correction; Sitting.
    • Mental demands: Analytic reasoning; Prolonged concentration.
    • Environmental factors: Standard office lighting, temperature, and noise.
    • Equipment: Keyboard; Telephone; Calculator; Copier/Fax.

    Qualifications

    • Associate degree or combination of formal education, training, and experience to acquire knowledge and skills generally equivalent to those possessed by a two-year college graduate. Bachelor’s degree preferred.
    • Required to obtain an Adjuster License within one year of hire date.
    • Previous experience in a claims or insurance office desirable.
    • Average typing skill (minimum 35 wpm).
    • Knowledge of claims handling procedures and insurance contracts.
    • Experience in the use of photocopier, computer terminal or word processor and other office equipment.
    • Ability to communicate with high level of skill both orally and in writing.
    • Ability to make timely decisions.
    • Excellent human relation skills and self-motivation required.
    • Ability to act in a confidential manner.
    • Knowledge of word processing software.

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed