Claims Specialist II, First Party Medical

ABOUT BRANCH Branch is on a mission to make insurance more accessible, so more people can be covered. We innovate using data, tech, and automation to simplify insurance from start to finish—we eliminated inaccurate quotes in favor of real prices, created a better way to bundle, and cut unnecessary costs in the traditional insurance process. Then we pass those savings along to our members. Basically, we’re doing insurance the way it was meant to be. But we didn’t just create the insurance we’ve always wanted, we also created the company we’ve always wanted to work for. As we redefine insurance, we also want to redefine what it means to work in insurance. Find out for yourself. Branch has a preference for candidates in Ohio, but is open to candidates located in AZ, FL, GA, IL, IN, IA, KS, KY, MD, MI, MO, NV, NC, OH, PA, SC, SD, TN, TX, and WI. Applicants must be currently authorized to work in the United States on a full-time basis. We are unable to sponsor or take over sponsorship of an employment visa at this time. Branch is remote first, with most Branchers choosing to work from home. Our headquarters are located in Columbus, Ohio, where we come together from time to time to build relationships and connect with each other in real life. We also have office space in Columbia and Concordia, Missouri as well as Forreston, Illinois. Once a year, the entire company gathers for “BranchFest”, a highlight of the year for many Branchers. About the role As a Claims Specialist II, First Party Medical at Branch, you’ll be assisting Branch members in their time of greatest need. When an auto claim is reported, you’ll be the face and voice of Branch to our members, ensuring they feel comfortable and have clear expectations about the claims process. We’re building a technology-first and data-driven claims experience to enhance client experience while eliminating traditional claims inefficiencies. We are in need of an experienced claims professional to investigate and resolve auto PIP & MedPay claims of varying complexity. The ideal candidate will be a member-focused “do-er”. You should not be afraid to roll their sleeves up to ensure we’re achieving industry best outcomes all while making sure we’re delivering on our promise to the Branch members. Key Responsibilities - Investigate and resolve non-litigated and litigated First Party PIP & MedPay claims within the claims department - Process non-medical benefits such as loss wages, funeral or other benefits - Contact insureds, attorneys, medical providers and other relevant parts to appropriately complete necessary investigations - Proactively keep all relevant parties apprised of claim status - Work within the claims system and with preferred partners to ensure quality documentation - Evaluate the need for medical management when appropriate - Process submitted bills in accordance with statutory requirements - Demonstrated excellent interpersonal written and verbal communication skills - identify potential fraud indicators and work closely with siu when appropriate - Ability to work non-traditional work hours - Resolve all claims in accordance with state and company guidelines - May perform other responsibilities as assigned Skills, Knowledge, and Expertise - 3+ years of progressive front line multi-state PIP & MedPay claims handling experience - 1+ years of experience with resolving litigated claims including directing outside panel counsel is preferred - Adjuster license(s) and experience handling claims in multiple states is strongly preferred (MI, NY, NJ, FL) - Knowledge of venue specific No-Fault laws and Regulations including MCCA - Experience with bill adjudication - Willing to go above and beyond to deliver an industry-leading member experience - Strong interpersonal skills - Ability to communicate at all levels of the organization - Creative, out of the box thinker who has a passion for helping others - Ability to “Call the Play” with imperfect information - Experience working remo…