Overview:
As the PIPP Benefits Administrator, you will investigate, assess and administer bodily injury claim benefits, as well as respond to an enquiry line on claimant enquiries. You will work collaboratively with your team and other departments to administer dental and chiropractic claims, and calculate permanent impairment entitlements for all injury claims.
Responsibilities:
Advise customers on benefits available, coverage and file progress and direct customers to the appropriate resource if the customer's inquiry cannot be addressed by the Benefit Administration Unit.
Independently process authorization and render decisions of moderate complexity for entitlements on medical expense claims.
Review current medical information to determine entitlement and request further information when required.
Contact customers, service providers, and/or Case Managers to confirm information or resolve discrepancies.
Enter benefit authorization and process permanent impairment payments.
Maintain adequate reserve and approve payments.
Leverage regulations, resources and processes and apply the intent to promote the most efficient, claimant appropriate resolution to the claim.
Work with peers and supervisors to promote a collaborative team environment.
Actively participate in identifying opportunities to improve departmental service quality.
Qualifications:
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