Medical Claim Representatives
Plymouth Rock Management Company of NJ - Wall, NJ

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Plymouth Rock, founded in 1982 by Jim Stone, former Massachusetts Insurance Commissioner, is a privately held insurance company that writes personal and commercial lines of business in the Northeastern United States. Today, Plymouth Rock, with more than $1billion in premiums underwritten and serviced, is comprised of a group of companies that were started or acquired to expand product offerings, channels of distribution, and the geographic footprint. With more than 800,000 policyholders, Plymouth Rock writes insurance through more than 800 independent agents.

The Plymouth Rock Group employs over 1,600 people and is headquartered in Boston, Massachusetts.

General Purpose of Job:

In this vital role, Medical Claim Representatives adjust first party personal injury claims according to NJ Department of Insurance and AICRA guidelines with the responsibility of handling an average of 200 pending claim files.

Essential Duties and Responsibilities:

The ideal candidate for this position should have functional knowledge in one or more of the following areas:
  • Medical Terminology
  • NJ PIP Claim Handling
  • Regulatory Requirements
  • Bill Processing and/or Coding
Our Claims reps initiate 24-hour contact on all new claim files and routinely identify potential fraud indicators.
Daily duties include initial investigation of PIP eligibility and application of various PIP issues, bill review and processing aspects. Candidates for the position must have excellent verbal and written communication skills.

Education and Experience:

Bachelor’s Degree (B.A.) from a four-year college or university; or 3 to 4 years related experience and/or training; or equivalent combination of education and experience.

Plymouth Rock Assurance Corporation - 21 months ago - save job