[Remote] Claims Specialist II PIP

Note: The job is a remote job and is open to candidates in USA. Mercury Insurance is a company dedicated to helping people reduce risk and overcome unexpected events. They are seeking a Claims Specialist II to investigate and manage Personal Injury Protection (PIP) claims, ensuring proper coverage and claims processing.ResponsibilitiesIdentifies and contacts each injured party to explain coverage and claims processVerifies coverage, eligibility and determines the Company’s course of actionMaintains claims files, evaluates claims using facts and supporting data on injury and wages lost due to injuryUpdates appropriate parties as needed, providing new facts as they become available, and their impact upon the analysis and settlement optionsVerifies the nature and extent of injury and/or wages lost by obtaining and reviewing appropriate records and documentationCarefully and thoroughly reviews all pertinent information and forwards the file to the Special Investigations Unit (SIU) when there is reasonable causeReviews and analyzes all information and submits request for payment of claims within company guidelines to supervisorThoroughly documents injury and treatment information as well as bills received for treatment and payments issuedContacts medical providers and injured parties to verify medical provider information, treatment received, and billing status. Submits files to supervisor for audit upon closingMaintains current knowledge of claims settlement procedures, state regulation, and policy changesIncludes completion of the formal claims training program, which may require overnight travel for at least 1 weekSkillsHigh School Diploma or GEDCompletion of in-house training programYou may be required to obtain a Company sponsored Adjuster's license to handle claims, to be secured upon hireAt least 6 months of related experienceOr equivalent combination of education and experienceSolid comprehension of basic principles and practices of Company policies upon completion of formal and informal Claims TrainingAbility to exercise sound judgment when interacting with customers and claimantsRequires extensive knowledge of medical terminology, and medical coding (CPT and ICD-10 coding)Requires extensive knowledge of Personal Injury Protection coverage(s), applicable state statutes/regulationsHas a passion for serving customers in their time of needPossesses advanced written and verbal communication skills to professionally represent the Company in multi-channel correspondence with internal and external customersCollaborates well with others. We are one team with a common goalAbility to build rapport utilizing emotional intelligenceViews conflict resolution as an opportunityHas self-motivation and accountability while working remotelyDemonstrated proficiency with MS Office products (Outlook, Word, Teams) and claims related softwareMust have dedicated workspace that is free from distractionsBachelor's DegreeCritical attention to detail and strong organizational skillsDemonstrates intellectual curiosity by seeking out efficiencies through process improvement or technologyTakes ownership of any process they can improveAssumes positive intent in all interactionsSeeks growth within and beyond this roleBenefitsCompetitive compensationFlexibility to work from anywhere in the United States for most positionsPaid time off (vacation time, sick time, 9 paid Company holidays, volunteer hours)Incentive bonus programs (potential for holiday bonus, referral bonus, and performance-based bonus)Medical, dental, vision, life, and pet insurance401 (k) retirement savings plan with company matchEngaging work environmentPromotional opportunitiesEducation assistanceProfessional and personal development opportunitiesCompany recognition programHealth and wellbeing resources, including free mental wellbeing therapy/coaching sessions, child and eldercare resources, and moreCompany OverviewMercury Insurance has offered quality insurance for personal auto insurance to homeowners insurance to mechanical breakdown protection. It was founded in 1962, and is headquartered in Los Angeles, California, USA, with a workforce of 5001-10000 employees. Its website is http://www.mercuryinsurance.com.



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