PIP Claims Training Specialist

Posted Yesterday
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Miami, FL, USA
In-Office
Mid level
Insurance
The Role
Trains new PIP claims adjusters on coverage, qualification, medical management, claims systems, payments, documentation, and performance expectations. Delivers refresher training, conducts target reviews, coaches employees, analyzes quality and file-review findings, updates training materials, and supports supervisors and adjusters with operational claim handling. Reviews claims, medical bills, payments, denials, inventory, and timeliness while providing feedback and escalating recurring concerns.
Summary Generated by Built In
COMPANY OVERVIEW:
Founded in 1989, United Automobile Insurance Company is an innovative and established organization looking for a PIP Claims Training Specialist to join our team. Family-owned, UAIC, is one of the largest privately held property and casualty insurance companies in the United States. The key to our growth and success is a commitment to providing quality service to our agents and customers, by providing disciplined underwriting, and strategic claims handling. Our ongoing efforts to invest substantial resources in personnel and technology are the foundation of our promise of assuring maximum efficiency and specialized operations in the industry. We are proud that our independent agents and customers have recognized our dedication by making UAIC the market leader in every state where we conduct business.
 Position summaryThe PIP Claims Training Specialist trains new PIP adjusters in Coverage & Qualification (C&Q), C&Q Fast Track (FT), Medical Management (MM) and MM Fast Track processes. The role also delivers recurring refresher training, Target Reviews, coaching and hands-on operational coverage for PIP supervisors and adjusters. Working with PIP management, Quality Assurance and Learning & Development (L&D), the specialist turns findings from file reviews and daily operations into targeted training that keeps claim handling accurate and consistent.ResponsibilitiesNew-hire training and transition
  • Train new hires on PIP Coverage & Qualification and Medical Management processes, including Fast Track workflows, systems and performance expectations.
  • Cover PIP policies, coverage and qualification requirements, documentation, medical bill processing, payments, denials and KPIs.
  • Reinforce classroom instruction with hands-on coaching and file reviews.
  • Support each new hire for about the first 30 days, through the transition to production.
  • Give supervisors weekly progress reports on each new hire's strengths and development areas.
  • Confirm new hires understand productivity, quality, diary, inventory and timeliness expectations before moving to the floor.
Recurring refresher training
  • Plan, develop and lead recurring refresher training sessions for PIP staff.
  • Use QA findings, Target Reviews, file reviews, audits and claim trends to set training priorities.
  • Deliver training on recurring errors, policy requirements, and new or revised processes and systems.
  • Partner with supervisors to identify individual, team and department-wide training needs.
  • Keep training materials accurate and current and evaluate training effectiveness.
Target Reviews and performance support
  • Conduct assigned Target Reviews of claim handling, documentation, timeliness and adherence to PIP standards.
  • Give objective, constructive and actionable feedback, and document findings in the performance management platform.
  • Help supervisors distinguish knowledge gaps, process issues and ongoing performance concerns.
  • Recommend targeted coaching, additional training or follow-up reviews.
  • Provide one-on-one or small-group training when recurring issues appear and follow up to confirm improvement.
  • Escalate significant or recurring concerns to management.
Floater and operational support
  • Provide temporary supervisor and adjuster coverage within assigned authority.
  • Review and approve coverage decisions and payments within assigned authority, escalating complex issues.
  • Conduct inventory sweeps for aging claims, pending decisions, overdue diaries and outstanding activities.
  • Review PEER reports and adjust medical bills as appropriate (pay, reduce, deny or escalate).
  • Work outstanding medical bills and urgent claims to prevent delays, interest and inventory buildup.
  • Support C&Q, C&Q FT, MM and MM FT units and help supervisors balance workload.
  • Perform other PIP claim-handling duties as assigned.
QualificationsRequired
  • 3-5 years of PIP claims experience, including Coverage & Qualification and Medical Management.
  • Active [State] adjuster license (for Florida: 2-20 All-Lines)
  • Strong technical knowledge of PIP coverage, qualification, medical bill processing and payments.
  • Experience reviewing claims and identifying errors, trends and improvement opportunities.
  • Effective communication, facilitation and coaching skills.
  • Ability to give objective feedback and address performance concerns professionally.
  • Strong analytical skills and attention to detail.
  • Sound judgment and the ability to make decisions within established authority.
  • Ability to work independently, manage competing priorities and move between trainer, reviewer and adjuster duties.
Preferred
  • Experience as a trainer, mentor, lead adjuster or acting supervisor.
  • Working knowledge of medical bill review, fee schedules and PEER review.
[Associate or Bachelor's degree] or equivalent experie

Skills Required

  • 3-5 years of PIP claims experience, including Coverage and Qualification and Medical Management
  • Active state adjuster license; Florida requires a 2-20 All-Lines license
  • Strong technical knowledge of PIP coverage, qualification, medical bill processing, and payments
  • Experience reviewing claims and identifying errors, trends, and improvement opportunities
  • Effective communication, facilitation, and coaching skills
  • Ability to provide objective feedback and address performance concerns professionally
  • Strong analytical skills and attention to detail
  • Sound judgment and ability to make decisions within established authority
  • Ability to work independently, manage competing priorities, and perform trainer, reviewer, and adjuster duties
  • Experience as a trainer, mentor, lead adjuster, or acting supervisor
  • Working knowledge of medical bill review, fee schedules, and PEER review
  • Associate or bachelor's degree or equivalent experience
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The Company
HQ: Chicago, IL
312 Employees
Year Founded: 1989

What We Do

United Automobile Insurance Company was incorporated on March 2, 1989 in Miami Gardens, FL to provide a high quality and low cost insurance product to the non-standard automobile insurance market. The company is family owned and it is one of the largest privately held property and casualty insurance companies in the United States

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