The ideal candidate will have a strong understanding of New Jersey PIP regulations, experience working closely with Special Investigations Units (SIU) on suspected fraudulent claims, and a proven ability to lead and develop claims professionals. This position is responsible for overseeing a team of PIP Claims Adjusters, ensuring accurate coverage and eligibility determinations, and supporting the investigation and resolution of complex Personal Injury Protection (PIP) claims.
Numbers & Facts
Location
Newark, New Jersey
Website
https://www.thekingstaffing.com
Description
Our client is seeking an experienced PIP Claims Supervisor to join their New Jersey claims operations. This position is responsible for overseeing a team of PIP Claims Adjusters, ensuring accurate coverage and eligibility determinations, and supporting the investigation and resolution of complex Personal Injury Protection (PIP) claims. The ideal candidate will have a strong understanding of New Jersey PIP regulations, experience working closely with Special Investigations Units (SIU) on suspected fraudulent claims, and a proven ability to lead and develop claims professionals.
Key Responsibilities:
Supervise and support a team of PIP Claims Adjusters responsible for evaluating coverage, eligibility, and claim validity in accordance with New Jersey PIP regulations.
Oversee complex coverage and eligibility investigations, ensuring accurate determinations and appropriate claims handling.
Collaborate closely with Special Investigations Units (SIU) to identify potential fraud, investigate suspicious claims, and determine appropriate next steps.
Monitor team productivity, claim quality, and overall performance while providing ongoing coaching, mentorship, and performance evaluations.
Review policy language, coverage provisions, and supporting documentation to ensure accurate eligibility decisions.
Develop and improve workflows to promote timely investigations, consistent claims handling, and efficient resolution.
Provide guidance on escalated claims, coverage disputes, and complex eligibility matters.
Partner with internal departments to maintain compliance with applicable insurance laws, regulatory requirements, and company procedures.
Requirements:
5 - 10+ years of experience handling PIP claims, with demonstrated supervisory or team lead responsibilities.
Thorough knowledge of New Jersey PIP laws, coverage requirements, and eligibility procedures.
Demonstrated experience collaborating with SIU on fraud investigations and suspicious claims.
Strong leadership, analytical, problem-solving, and decision-making skills.
Proficiency in Microsoft Word and Excel, including the ability to monitor and report on team performance metrics.
Familiarity with claims management systems and regulatory compliance.
Salary/Benefits:
$85,000–$100,000 annual base salary, depending on experience
Competitive medical, dental, and vision insurance plans