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Personal Injury Protection Claim Representative Jobs

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PIP Claim Representative II - Michigan

Claim Representative II This is the intermediate level of the claims handling career path responsible for managing a caseload of Michigan No-Fault Personal Injury Protection (PIP) claims of moderate ...

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Personal Injury Protection Claim Representative information

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How much do personal injury protection claim representative jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for personal injury protection claim representative in the United States is $24.12, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $27.40 per hour, depending on experience, location, and employer.

What does a personal injury protection claim representative do?

A Personal Injury Protection (PIP) Claim Representative evaluates and processes insurance claims related to personal injuries sustained in automobile accidents, regardless of fault. They review medical records, verify policy coverage, communicate with claimants, healthcare providers, and legal representatives, and determine the appropriate payout according to policy terms. Their goal is to ensure claims are handled efficiently and fairly while complying with all relevant laws and regulations.

What are the key skills and qualifications needed to thrive as a personal injury protection claim representative?

To thrive as a Personal Injury Protection Claim Representative, you need a strong understanding of insurance policies, claim investigation, and legal compliance, often supported by a bachelor's degree or relevant work experience. Familiarity with claims management software, document management systems, and sometimes state adjuster licensing is typically required. Excellent communication, negotiation, and attention to detail are vital soft skills for interacting with claimants and managing sensitive information. These skills ensure accurate claim resolution, regulatory compliance, and customer satisfaction in a detail-oriented and regulated field.

What are some common challenges faced by personal injury protection claim representatives in managing caseloads?

Personal Injury Protection (PIP) Claim Representatives often manage a high volume of cases simultaneously, which requires strong organizational and time management skills. Balancing thorough investigations, timely communication with claimants, and ensuring compliance with state regulations can be challenging, especially when dealing with complex or disputed claims. Representatives must also stay updated on changing legal requirements and maintain detailed documentation for each claim. Effective collaboration with medical professionals, attorneys, and other insurance staff is essential to resolve claims efficiently and fairly.

What cities are hiring for Personal Injury Protection Claim Representative jobs?

Cities with the most Personal Injury Protection Claim Representative job openings:

What are popular job titles related to Personal Injury Protection Claim Representative jobs?

For Personal Injury Protection Claim Representative jobs, the most frequently searched job titles are:

Senior Personal Injury Protection Adjuster

Chicago, IL • On-site

First Chicago Insurance Company
Insurance Services • 51 - 200 employees
Learn more about First Chicago Insurance Companyexternal

$54K - $97K/yr

Other

Medical, Dental, Retirement, PTO

Re-posted 6 days ago

First Chicago Insurance rating

5.7

Company rating: 5.7 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

Senior Personal Injury Protection Adjuster

As a Senior Personal Injury Protection ("PIP") Specialist, you will be responsible for evaluating and managing claims filed under the Personal Injury Protection ("PIP") coverage of commercial and personal insurance policies. You will investigate claims, assess injuries, negotiate settlements, and ensure compliance with relevant laws and regulations.

Key Responsibilities

  • Review and assess PIP claims to determine coverage, liability, and the extent of injuries.
  • Conduct thorough investigation into the circumstances surrounding each claim, including obtaining medical records, police reports, and statements.
  • Evaluate the nature and severity of injuries reported by first-party claimants through medical documentation, diagnostic tests, and expert opinions.
  • Determine the applicability of PIP coverage based on policy terms, state regulations, and the specifics of each claim.
  • Negotiate fair and equitable settlements with claimants, attorneys, and medical providers to resolve claims effectively.
  • Maintain detailed and accurate records of claim files, including correspondence, investigation findings, settlement offers, and payment transactions.
  • Communicate effectively with first-party claimants, legal representatives, medical providers, and other stakeholders to provide updates, address concerns, and facilitate the claims process.
  • Ensure compliance with all relevant laws, regulations, and company policies throughout the claims handling process.
  • Provide exceptional customer service to first-party claimants by addressing inquiries promptly and offering assistance throughout the claims process.
  • Manage pre-authorization requests and identification of cases requiring an IME.
  • Stay abreast of industry trends, legal developments, and medical advancements relevant to PIP claims to enhance expertise and effectiveness in the role.
  • Complete a detailed analysis of claims where a new suit has been received inclusive of coverage, liability, and damages
  • Manage and oversee litigation processes, working closely with legal counsel to develop strategies for case resolution

Qualifications

  • Bachelor's degree or equivalent work experience
  • Previous experience in auto claim adjusting, preferably with a focus on commercial PIP claims in NJ and PA.
  • Previous experience with AICRA in New Jersey and MVFRL in PA.
  • Strong knowledge of insurance principles, coverage types, and regulations governing PIP
  • Excellent analytical skills with the ability to assess complex situations and make informed decisions
  • Effective negotiation skills and the ability to resolve conflicts and disputes
  • Exceptional communication skills, both verbal and written, and the ability to convey information clearly and concisely
  • Detail-Oriented with strong organizational and time management skills
  • Proficiency in relevant software applications for claims management and documentation
  • Previous litigation experience is preferred but not required.
  • Prior Non-Standard Auto Claims experience a plus, not required.

First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive:

  • Competitive Salaries
  • Commitment to your Training & Development
  • Medical and Dental
  • Telemedicine Benefit
  • 401k with a generous company match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement Training Programs
  • Wellness Program
  • Fun company sponsored events
  • And so much more!

Estimated Compensation Range: $54,750/year-$97,500/year*

*Published ranges are estimates

What First Chicago Insurance employees say

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