Esurance PIP Specialist I in Tampa, Florida

Esurance is looking for a Medical Specialist I to join a dynamic and award-winning team of individuals who are committed to making insurance smarter, easier, and dare we say- cooler. As part of a growing company that is focused on providing an outstanding customer experience, you’ll have the opportunity to expand your skills and discover your potential.

If you’re looking for a career at a socially conscious company that offers great benefits — including matching 401k and tuition reimbursement — then you may have just found your new home.

Esurance combines the spunk of a startup company with the backing of Allstate (the largest publicly held personal lines insurer in the U.S.) to create a unique, energized, and exciting place to work.

The Medical Specialist Reps are essential to our claims team, using their medical knowledge and investigative abilities to adjust medical claims, while advocating for our customers throughout the claims process. In this role, one will investigate and analyze coverage, liability, fraud and cause of injury. Additionally, the role will perform policy research and interpret medical records to ensure payment accuracy.

Job Responsibilities:

  • Interacts daily with customers taking statements and research medical records to understand nature and extent of injury and medical conditions

  • Plans and conduct coverage investigations

  • Handles files where noncomplex eligibility investigations are necessary

  • Identifies and address wage and replacement service exposures on medical claims, with management review

  • Reviews and research wage loss expenses and documentation for payment consideration, with management review

  • Answers questions from insured, claimants, and attorneys to resolve problems and concerns.

  • Reviews policy coverage and documents/processes moderate complex personal injury protection claims with minimal managerial assistance.

  • Evaluates medical claims for potential fraud issues, loss control and recovery in accordance with insurance policy contracts, medical bill coding rules and state regulations

  • Uses claims systems to locate prior losses and to maintain claim information.

  • Addresses diaries, correspondence, emails, and voicemails timely.

  • Documents conservations and recorded statements from involved parties, correspondence, bills and actions.

  • Documents files and pays submitted bills according to procedures.

  • Sends correspondences and completes actions to satisfy department of insurance and/or state specific regulations.

  • Submits reports to underwriting regarding claims issues.

  • Opens reserves appropriate to reflect exposure to the policy.

  • Identifies bodily injury and un-insured motorist claims and reassigns to appropriate department.

  • Refers files to special investigation unit and assists with direction of the low complex investigation

  • Handles claims with an exposure of up to $100,000

  • Authority level up to $15,000

Qualifications:

  • Detail-oriented with strong organizational skills, able to work well under deadlines in a changing environment and perform multiple tasks effectively and concurrently.

  • Demonstrated ability to work effectively under pressure and within a collaborative team oriented environment using sound judgment in decision-making.

  • Excellent communication skills both oral and written with strong analytical skills.

  • Excellent customer service and negotiation skills

  • Demonstrated proficiency with Microsoft Office products (Excel, PowerPoint, and Word).

  • Demonstrated knowledge of different bodily injury and/or loss claims.

  • Must be able to travel and attend off-site meetings 5% of the time.

Experience / Education:

  • Bachelor’s degree in a related field or equivalent education preferred.

  • Three years of insurance claims handling experience required.

  • Insurance course work experience preferred.

Physical Demands and Work Environment:

Representative of those that must be met by an employee to successfully perform the essential functions of this job. Must be able to operate a PC and sit for extended periods of time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Benefits

At Esurance, being committed to our employees is not just something we say, it’s something we do. Our benefits package is designed to help our associates stay healthy, meet their long-term financial goals, and balance the demands of work and personal life. Esurance rewards hard work, dedication, and creativity with competitive salaries and a generous bonus system. We are committed to our employees and we are dedicated to creating a diverse, positive, innovative and team-oriented work environment.

Health & wellness

  • Medical, vision, and dental insurance

  • Life insurance (company-paid and supplemental)

  • Accidental death and dismemberment coverage

  • Wellness coaching and incentives

  • Group critical illness coverage

  • Accident indemnity and hospital indemnity plans

  • Group legal

Savings

  • 401(k) plan with annual matching contribution

  • Referral bonuses

  • Performance-rewarding bonus system

  • Tuition assistance program (up to $5,250 per year)

  • Health savings and flexible spending accounts

  • Commuter benefits

Family & Community

  • Adoption assistance

  • Maternity leave

  • Buckle Up Baby program

  • Pet insurance discount

  • Charitable gift matching

  • Give Time, Get Time volunteer program

  • Employee Assistance Program

Time off

  • Short-term disability

  • Long-term disability (employee-paid option)

  • Paid time off (holidays, vacation, personal choice days)

ID: 36594

External Company Name: Esurance Insurance Services, Inc.

External Company URL: www.esurance.com

Street: 160 Kelsey Lane