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Med/PIP Specialist I

26384

We are Farmers!

We are… more than just your favorite commercials.  At Farmers, we strive to deliver peace of mind to our customers by providing protection and comprehensive advice and delivering in the moments of truth. That means having people who can help us meet changing customer and business needs. Farmers high-performance culture is focused on results and the people who achieve them. We hold ourselves and others accountable for sustainably growing the business and each other. We seek solutions, own our actions, and grow through discomfort. We see setbacks as opportunities while continuously asking ourselves how we impact our customers. 

 

Farmers is an award winning, equal opportunity employer, committed to the strength of a diverse workforce. We are dedicated to supporting the well-being of our people through our extensive suite of benefits, as well as the well-being of the communities we serve through employee volunteer programs and nonprofit partnerships. Helping others in their time of need isn’t just our business – it’s our culture!  To learn more about our high-performance culture and open opportunities, check out www.Farmers.com/careers/corporate and be sure to follow us on Instagram, LinkedIn, and TikTok. 

 

Workplace: Hybrid ( #LI-Hybrid ), Remote ( #LI-Remote )

Farmers believes in a culture of collaboration, creativity, and innovation, which thrives when we have the ability to work flexibly in a virtual setting as well as the opportunity to be together in person. Our hybrid work environment combines the best of both worlds with at least three (3) days in office and up to two (2) days virtual for employees who live within fifty (50) miles of a Farmers corporate office. Applicants beyond fifty (50) miles may still be considered.

Job Summary

Locations: We are hiring for 2 areas. Please see below.

Caledonia, MI - This position will be Hybrid (3 days a week in the office) to the office located in 5665 N. Kraft Lake Dr. Caledonia, MI 49316

Colorado - If you live within a 50 mile radius to 10333 E. Dry Creek Road Englewood, CO 80112 you will be hybrid (3 days a week in office). If outside of this radius, you will be considered virtual.

 

  • Proactively processes Med Pay and/or Personal Injury Protection (PIP) claims while delivering superior customer service.
  • Confirms coverage and eligibility.
  • Investigates and establishes damages.
  • Negotiates and/or pays assigned claims.
  • Communicates with claim owners and other specialists to facilitate claim resolution.

Essential Job Functions

  • Customer Relationship
  • Makes timely contact with customer
  • Explains claims process to customer
  • Explains policy benefits to customer
  • Confirms facts of loss Establishes expectations (future contact timing, m method of contact, etc.)
  • Investigation
  • Determines policy coverage applicability
  • Determines eligibility Identifies policy and coverage issues and escalates to supervisor
  • Secures supporting documents such as, medical records, bills, and wage loss verification Identifies subrogation opportunities and refers claim to Subrogation department to follow-up
  • Obtain additional information from all parties as needed to confirm proximate cause of loss and mechanism of injury Recognizes potential fraudulent claims and escalates to supervisor for review
  • Communicates with underwriting on policy issues
  • Evaluation Reviews and analyzes medical bills, records, wage loss documentation, and other information
  • Reviews all investigation materials for causal relationship between the claim incident and the injuries reported
  • Utilizes available resources and tools to ensure accuracy of evaluation of medical treatment.
  • Assesses owed benefits Reviews claims with more complex investigation questions or issues with supervisor
  • Claim Resolution Identifies need for medical intervention, such as an Independent Medical Exam or peer review, and initiates the process
  • Recognizes and resolves disputes over covered benefits, medical bill amounts, etc. with customer or provider as appropriate
  • Negotiates and settles claims based on the merits of the claim
  • File Management Proactively manages claim inventory to ensure all assigned claims are handled to completion in a timely fashion, including follow-up contacts, bill payment, etc., compliant with regulatory requirements
  • Utilizes claim system and other technologies to document file activities, strategy, and communication with customers, attorneys and medical providers
  • Ensures that all correspondence to customers is appropriate and professional
  • Discusses status of injuries and medical treatment plans with customers and medical providers
  • Identifies Medicare eligibility and provides appropriate notification to customer as required
  • Responds to customer and provider inquiries and resolves complaints promptly
  • Completes assigned training and activities to develop the knowledge, skills and abilities required to complete the job duties.
  • Performs other duties as assigned

Experience Requirements

Basic critical thinking, negotiation, analytical and time management skills. Strong customer service skills. Proficient in use of computer, internet and Microsoft Office applications (Word, Excel). General work experience with demonstrated customer service and time management skills is preferred. Maintain an active adjuster’s license in states as required.

Education Requirements

High school diploma or equivalent required. Bachelor’s degree preferred.

Benefits

  • Farmers offers a competitive salary commensurate with experience, qualifications and location.
    o CO Only: $23.54 - $34.43 
  • Bonus Opportunity (based on Company and Individual Performance)
  • 401(k)
  • Medical
  • Dental
  • Vision
  • Health Savings and Flexible Spending Accounts
  • Life Insurance
  • Paid Time Off
  • Paid Parental Leave
  • Tuition Assistance
  • For more information, review “What we offer” on https://www.farmers.com/careers/corporate/#offer

 

Job Location(s): US - CO - Englewood, US - CO, US - MI - Caledonia

 

Anticipated application deadline: At Farmers, the recruitment process is designed to ensure that we find the best talent to join our team. As part of this process, we typically close open positions within 8 to 21 days after posting. If you are interested in any of our open positions, we encourage you to submit your application promptly.

 

Farmers will consider for employment all qualified applicants, including those with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring Ordinance or other applicable law.  Pursuant to 18 U.S.C. Section 1033, Farmers is prohibited from employing any individual who has been convicted of any criminal felony involving dishonesty or a breach of trust without prior written consent from the state Department of Insurance.

 

Farmers is an Equal Opportunity Employer and does not discriminate in any employer/employee relations based on race, color, religion, gender, sexual orientation, gender expression, genetic information, national origin, age, disability, marital status, military and veteran's status, or any other basis protected by applicable discrimination laws. 

 

Want to learn more about our culture & opportunities? Check out www.Farmers.com/careers/corporate and be sure to follow us on Instagram, LinkedIn, and TikTok.


Nearest Major Market: Denver

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