United Automobile Insurance Company · 15 hours ago
PIP Coverage and Qualification Adjuster
United States
Full-time
Remote
Mid Level
3+ years expUnited Automobile Insurance Company is an established organization looking for a Coverage and Qualification Adjuster to join their team. This role involves reviewing and processing Personal Injury Protection claims, ensuring compliance with company policies and state regulations, and facilitating timely settlements.
Auto InsuranceAutomotiveInsurance
Responsibilities
Review and assess PIP claims to determine coverage eligibility
Analyze medical records, police reports, and other relevant documents to evaluate the extent of injuries and to establish proof of loss
Interpret insurance policies, contracts, and state regulations to determine the extent of coverage applicable to each claim
Communicate with claimants, medical professionals, attorneys, and other parties involved in the claim process to gather necessary information and documentation
Provide clear and concise explanations of coverage decisions to claimants
Conduct interviews with claimants to gather necessary information that supports an objective final disposition of the claims. These interviews may be conducted under oath or via phone
Maintain accurate and organized claim files with all pertinent information, including correspondence, medical records, and assessment reports
Issue payments for approved claims in accordance with company policies
Ensure compliance with state laws, regulations, and company policies in all claim handling activities
Generate and submit reports on claims activity, trends, and performance metrics
Identify and investigate potentially fraudulent activities related to PIP claims
Collaborate with the special investigation unit (SIU) when fraud is suspected
Provide excellent customer service by addressing inquiries, concerns, and providing timely updates to claimants
Prepare reports and documentation for internal purposes, regulatory compliance, and potential legal proceedings
Qualification
Required
Auto PIP Claims experience required
Active Adjuster's license required
Knowledge of insurance principles, policies, and procedures
Strong analytical, negotiation, and communication skills
Ability to work independently and efficiently manage a caseload
Proficient in Guidewire, Word, Excel, Windows-based applications and internet usage
Must be familiar with forms, procedures, regulations, coverages, and claims processes
Must be able to exercise good judgment and state opinions assertively
Must be able to write and speak clearly and concisely
Must be able to perform work effectively in a highly intense environment and handle multiple tasks and demands simultaneously
Must illustrate analytical skills to identify, gather, and organize information
Must be able to work independently in a team environment
Preferred
Associate or bachelor's degree preferred and/or a minimum of 3 years of related work experience, preferably with PIP claims
Bilingual (English & Spanish) preferred
Benefits
401(k) Retirement Savings Plan with employer match.
Comprehensive Medical, Prescription Drug, Vision, and Dental Insurance
Paid Time Off, Holidays, and Leave programs.
Flexible spending accounts
Basic Life Insurance and Voluntary Life/ADD
Short Term and Long-Term Disability
Company
United Automobile Insurance Company
Provide a high quality and low cost insurance product to the non-standard automobile insurance market.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
$45MKey Investors
Victory Park Capital
2018-04-26Series Unknown· $45M
Leadership Team
Ivonne Mena Cossio, SHRM-CP
Chief Human Resources Officer
Jim Sutton
Chief Product Officer
Recent News
2025-08-26
2024-04-06
Company data provided by crunchbase