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Personal Injury Protection Claims Examiner Jobs (NOW HIRING)

Venbrook

Claims Examiner

Los Angeles, CA · On-site

... personal risk insurance products and programs. Venbrook Claims brings together decades of ... bodily injury claims for public entity clients from assignment through resolution. In this role ...

Venbrook

Claims Examiner

Los Angeles, CA · On-site

... personal risk insurance products and programs. Venbrook Claims brings together decades of ... bodily injury claims for public entity clients from assignment through resolution. In this role ...

York Risk Services

$70K - $80K/yr

... Examiner, Auto | Bodily Injury PRIMARY PURPOSE OF THE ROLE: To analyze and process complex bodily ... Processes complex auto commercial and personal line claims, including bodily injury and ensures ...

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Personal Injury Protection Claims Examiner information

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How much do personal injury protection claims examiner jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for personal injury protection claims examiner in the United States is $21.11, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $23.56 per hour, depending on experience, location, and employer.

What does a personal injury protection claims examiner do?

A Personal Injury Protection (PIP) Claims Examiner is responsible for reviewing and processing insurance claims related to personal injuries, typically arising from auto accidents. They evaluate the validity of claims, review medical records and accident reports, and determine the extent of coverage based on state laws and policy terms. These professionals communicate with claimants, medical providers, and legal representatives to ensure all necessary documentation is provided and verify the legitimacy of the claims. Their goal is to ensure that claims are handled efficiently, fairly, and in accordance with regulatory guidelines.

What is the difference between Personal Injury Protection Claims Examiner vs Auto Claims Adjuster?

AspectPersonal Injury Protection Claims ExaminerAuto Claims Adjuster
CredentialsInsurance licenses, claims certificationInsurance licenses, claims certification
Work EnvironmentInsurance company offices, remote optionsField work, insurance offices
Industry UsageAuto insurance, PIP claimsAuto insurance, vehicle damage claims
Primary FocusEvaluating PIP injury claims and coverageAssessing vehicle damage and liability

While both roles involve insurance claims, a Personal Injury Protection Claims Examiner specializes in evaluating PIP injury claims and coverage, often working within insurance companies. An Auto Claims Adjuster handles vehicle damage assessments and liability determinations, sometimes working in the field. Both require similar credentials and are integral to auto insurance processes, but their focus and work environments differ.

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

To thrive as a Personal Injury Protection Claims Examiner, you need a thorough understanding of insurance policies, medical terminology, and claims processing, typically supported by experience in insurance or a related field. Proficiency with claims management software, medical billing systems, and familiarity with state regulations is commonly required, and some employers may seek industry certifications such as AIC or CPCU. Attention to detail, analytical thinking, and strong interpersonal communication help examiners accurately assess claims and interact with policyholders and medical providers. These skills ensure efficient, fair, and legally compliant claims processing, which protects both the company and the insured parties.
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What states have the most Personal Injury Protection Claims Examiner jobs?

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What job categories do people searching Personal Injury Protection Claims Examiner jobs look for?

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Personal Injury Protection Claims Examiner jobs near you
Infographic showing various Personal Injury Protection Claims Examiner job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 21% Part Time, 1% Temporary, 4% Contract, and 1% Nights. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $43,917 per year, or $21.1 per hour.

Claims Examiner | No Fault- PIP | Lit Required | New York

Sedgwick

New York, NY • On-site

$75K - $85K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 15 days ago

Sedgwick rating

7.6

Company rating: 7.6 out of 10

Based on 321 frontline employees who took The Breakroom Quiz

211th of 307 rated insurance

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
Claims Examiner | No Fault- PIP | Lit Required | New York
PRIMARY PURPOSE OF THE ROLE : Investigates, negotiates, and resolves personal injury protection (PIP) and medical payments (Med Pay) claims in accordance with policy provisions, best practices, and jurisdictional requirements. Responsible for the input of claim data and guiding insureds and claimants through the claim process and options.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE:
  • Manages claims and adjusts moderately complex to complex, PIP/Med Pay, claims across multiple jurisdictions.
  • Investigates loss details, evaluates, negotiates, and resolves claims within appropriate authority guidelines; maintains a high level of productivity, confidentiality, and customer service.
  • Reviews assigned files and claim instructions for proper claim handling, establishes reserves and issues payment based on claim details and claim damages.
  • Clearly documents thought process, investigation, evaluation, negotiation, and settlement decisions.
  • Prioritizes assigned claims workload to keep policyholders and other involved parties informed and provides timely claims status updates.
  • Serves as a subject matter expert on of state laws, regulations, statutes, and procedures to ensure proper handling of assigned claims.
  • Delivers best in class claim service through setting appropriate expectation proactive communications with customers, brokers, and other claim professionals throughout the claims process.
  • Works independently within significant limits and authority on assignments of higher technical complexity and coordination.
  • Identifies possibly suspicious claims.
  • Takes recorded statements.
  • Identifies, confirms, and makes coverage decisions on complex claims.

QUALIFICATIONS
Education & Licensing: Six (6) years of related experience, to include three (3) years of PIP/Med pay adjusting experience, or equivalent combination of education and experience required.
  • Bachelor's degree from an accredited college or university preferred.
  • Professional certification as applicable to line of business preferred.
  • Secure and maintain the State adjusting licenses as required for the position.

TAKING CARE OF YOU
  • Flexible work schedule.
  • Referral incentive program.
  • Career development and promotional growth opportunities.
  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Work environment requirements include -
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $75,000 to $85,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Always Accepting Applications.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

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