Personal Injury Protection; PIP Adjuster

Overview

Reserv is an insurtech creating and incubating AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with experience in SaaS and digital claims, Reserv is venture-backed and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike.

We have ambitious goals and need adjusters who can work in an evolving environment. If building a leading TPA and tackling the long-standing challenges of the claims role sounds exciting, we would love to meet you.

We are seeking a detail-oriented Personal Injury Protection (PIP) Resolution Specialist to join our team. The PIP Resolution Specialist will investigate and evaluate PIP/MP claims and coverage. The ideal candidate will have strong analytical skills, excellent communication abilities, and a commitment to providing exceptional customer service. The role includes handling an inventory of PIP claims and delivering service to all constituents of the claim.

You will design processes to support quick claim resolution and collaborate with product and engineering teams to identify technology and process improvements.

• Provide prompt, courteous, high-quality customer service to policyholders and claimants by answering calls, filing claims, and resolving requests.
• Investigate PIP/MP claims to determine coverage, extent of injury, and evaluate medical billing for necessity and relatedness to the claim.
• Gather relevant documentation, interview involved parties, explain policy and coverage, advise on appropriate course of action, and resolve related medical expenses.
• Assess validity of PIP claims based on evidence, medical records, and applicable laws; determine appropriate settlement amount and ongoing plan for resolution.
• Manage an inventory of claims, establish initial reserves for potential exposures, and adjust as needed throughout the claim lifecycle.
• Ensure compliance with state regulations, policy provisions, and standard operating procedures.
• Maintain regular communication with claimants, policyholders, attorneys, medical providers, and other parties to provide updates and facilitate the claims process within approved payment authority.
• Prepare thorough and accurate claim reports with investigation findings, damages, and rationale for decisions.
• Provide input for continuous development of claims guidelines, best practices, and process improvements.
• Oversee and direct outside investigative service providers and collaborate with clients and counsel to resolve the claim.
• Engage in learning opportunities to build knowledge of commercial lines claims, court decisions, and policy changes.

• Bachelor's degree (or equivalent experience).
• Minimum of 3 years of experience in Personal Injury Protection, ideally with experience handling NY, NJ, MI, FL, KY, and related states.
• Experience with handling commercial or ride-share policies is highly preferred.
• Subrogation referrals;
  Bodily Injury and coordination of benefits between PIP and UM/UIM.
• Arbitration and/or formal PIP/MP litigation experience.
• Active adjuster license(s) with willingness to obtain all required licenses within 45 days (home-state license held).
• Knowledge of state regulations, policy provisions, and standard operating procedures.
• Ability to analyze and evaluate complex data and make sound decisions.
• Curious and motivated to solve problems and challenge the status quo.
• Desire for continuous professional development and willingness to travel for client and claims needs.
• Fine to work in a remote-first environment and comfortable with technology-enabled work tools.

• Generous health-insurance package with nationwide coverage, vision, and dental.
• 401(k) retirement plan with employer matching.
• Competitive PTO and generous family leave policy.
• Work from anywhere to support work-life balance.
• Apple laptop, large second monitor, and other quality-of-life equipment.

Reserv values diversity and believes that a variety of perspectives leads to innovation and success. We are actively seeking candidates from all backgrounds. We support equal employment opportunities and we do not discriminate on protected status.