NJM Insurance Group · 3 months ago
Personal Injury Protection (PIP) Representative (I/II/ Sr.)
NJM - Parsippany
Full-time
Hybrid
New Grad, Entry, Mid, Senior Level
$50K/yr - $58K/yr
0+ years expNJM Insurance Group, a top-rated insurance company, is seeking a Personal Injury Protection Representative to manage and evaluate claims related to personal injury protection. The role involves reviewing coverages, determining coverage issues, and maintaining communication with involved parties throughout the claims process.
InsuranceManufacturingTransportation
Responsibilities
Review PIP coverages and/or identify coverage issues and investigate and analyze the loss event, the injury and other relevant information to make a determination as to coverage and course of action
Evaluate claims for fraud indicators and potential underwriting issues and process appropriate referrals. Conduct activities in compliance with state and company regulations and guidelines
Render final coverage determination within regulatory guidelines: Maintain communication with involved parties during the course of the claim, via written and/or verbal communication, to provide relevant determinations and/or information
Maintain communication with involved parties during the claim, via written and/or verbal communication, to provide relevant determinations and/or information. Concisely and accurately document all actions taken throughout the course of the claim
Manage all requests for medical treatment, durable medical equipment, PIP Care Paths, medical guidelines, and policies, internal and/or external peer reviews and/or IMEs, when required, communicate determinations to appropriate parties within three business days
Request necessary Independent Medical Examinations and render determinations for additional treatment or termination benefits
Establish adequate medical and non-medical benefits reserves for the life of the claim and adjust reserves, if needed
Calculate and issue non-medical benefits (wages, essential services, death benefits)
Demonstrates knowledge in NJ and in other states and is able to apply regulatory requirements appropriately
Understands and applies all process and regulatory knowledge associated with arbitration and subrogation. Effectively utilizes all applications and manages time and responsibilities
Qualification
Required
Excellent verbal and written communication skills, knowledge of Microsoft suite
Strong interpersonal and customer service skills
Good organizational, time-management, and data entry skills
Decision-making and multi-tasking capabilities
High school diploma or GED required
Preferred
Bachelor's degree
3-5 years of claims handling experience
5-7 years of claims handling experience
Benefits
Medical Insurance (Blue Cross Blue Shield)
Dental Insurance (Delta Dental)
Vision (Delta Vision/ VSP)
Flexible Spending Account
Discounts on NJM auto insurance
Tuition reimbursement
Life insurance
Plus, additional company discounts for items like travel, service, car rental and more!
401(k) with employer match up to 8% and additional service-based contributions
Health, Dental, and Vision insurance
Life and Disability coverage
Generous PTO
Paid Sick Leave
Paid parental leave in addition to state-mandated leave
Company
NJM Insurance Group
NJM (New Jersey Manufacturers) is an auto, homeowners, renters, commercial auto, umbrella and workers' compensation insurance providers.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Chris Malone
SVP, CFO & Treasurer
Carol Voorhees
Senior Vice President & Chief Information Officer
Recent News
2026-01-16
Company data provided by crunchbase