Job Description

Commercial Auto Claims Representative (PIP) – Temp to Hire

Job Summary

Seeking a highly skilled and experienced Commercial Auto Claims Representative (PIP) to join a team on a temporary-to-hire basis. This fully remote position offers an exciting opportunity to work with a reputable organization known for its strong commitment to service, innovation, and integrity. The ideal candidate will have a proven track record in handling commercial auto claims, particularly Personal Injury Protection (PIP) and Medical Payments (MedPay), with multi-state experience being a significant advantage.

Compensation Package

• Hourly Rate: $37 - $41 per hour
• Employment Type: Temporary to Hire
• Remote Work: 100% remote

Responsibilities

As a Commercial Auto Claims Representative (PIP), your primary responsibilities will include:

• Investigating and managing assigned commercial auto first-party medical benefit claims.
• Verifying applicable coverage, eligibility, benefits, limits, deductibles, exclusions, and coordination-of-benefits requirements.
• Reviewing policy language and applying state-specific PIP, no-fault, and MedPay statutes, regulations, and fee schedules.
• Evaluating accident information, medical records, itemized bills, treatment notes, and wage documentation to determine benefit eligibility and payment.
• Reviewing medical bills for coding accuracy, duplication, relatedness, reasonableness, and necessity.
• Processing covered medical expenses, wage-loss benefits, and other PIP benefits in compliance with policy terms and applicable laws.
• Maintaining accurate benefit payment ledgers and monitoring remaining limits, deductibles, and offsets.
• Communicating professionally with insureds, claimants, medical providers, attorneys, and internal partners regarding claim status and benefit determinations.
• Recognizing and escalating disputed treatments, suspected fraud, coverage concerns, and other issues requiring legal or supervisory review.
• Preparing timely and accurate correspondence, including requests for information, explanations of benefits, and coverage decisions.
• Managing an active claim inventory efficiently while meeting quality, timeliness, and customer-service expectations.
• Coordinating with bodily injury, liability, litigation, SIU, and vendor teams as necessary.
• Obtaining and maintaining required state adjuster licenses.

Qualifications/Requirements

We are looking for candidates who meet the following criteria:

• Experience: Minimum of 3+ years of auto claims experience, including hands-on PIP and/or MedPay claim handling. Multi-state PIP experience is preferred.
• Knowledge: Strong understanding of no-fault/PIP and MedPay coverage, medical terminology, medical billing, benefit limits, fee schedules, and state-specific claim deadlines.
• Skills:
  • Ability to interpret insurance policy language and evaluate medical documentation.
  • Excellent written and verbal communication skills, including professional correspondence with providers and attorneys.
  • Strong organizational, analytical, and time-management skills.
  • Proficiency in computer systems and the ability to adapt quickly to new claim systems and procedures.
• Education: Bachelor’s degree required. Equivalent relevant claims experience may be considered. Insurance industry designations are a plus.
• Licensing: Must have a home state adjuster license and the ability to obtain Texas and Florida licenses (costs covered by the company).
• Additional Requirements:
  • Familiarity with salvage platforms and total loss claims is preferred.
  • Cargo claims experience is a plus.
  • Ability to travel for company or claim-related events if needed.

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