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Kemper is one of the nation’s leading specialized insurers. Our success is a direct reflection of the talented and diverse people who make a positive difference in the lives of our customers every day. We believe a high-performing culture, valuable opportunities for personal development and professional challenge, and a healthy work-life balance can be highly motivating and productive. Kemper’s products and services are making a real difference to our customers, who have unique and evolving needs. By joining our team, you are helping to provide an experience to our stakeholders that delivers on our promises.

As a PIP Specialist II, you are responsible for the investigation, valuation, establishment of exposures, negotiation and settlement of assigned PIP and med pay claims. Ensures that all assigned claims are concluded promptly, equitably and economically within the provisions of the policy contract applicable law and in accordance with the damages presented.

SPECIFIC ACTIVITIES :

1. Reviews loss notices to verify coverage and determine exposures. Enters exposures into the claims system.

2. Contacts insureds and claimants to further develop the extent of injuries, and expected future expenses. Develops plan for the ongoing development of the file.

3. Investigates coverage questions as needed. Handles questions on coverage with a reservation of rights letter and/or non-waiver agreement. Conducts proper investigations so that decisions can be made as to applicable coverage as quickly as possible.

4 . Determines eligibility for benefits and priority of coverage available. Rules out other potential coverage and determines applicability of coverage. Submits written opinion to manager regarding questionable coverage situations.

5 . Recognizes the need for and sends required No-Fault and other claim forms in a timely manner.

6 . Audits and verifies all medical bills, wage forms or other documents submitted as proof of loss or disability to determine benefits due in accordance with the no-fault law, policy and standards of "reasonable and customary."

7 . Determines benefits to be paid and assesses the need for additional documentation. All payments and requests are to be made within the guidelines of the State regulations.

8. Through use of medical and technical knowledge and RN support, identifies cases where treatment or expenses may not be reasonable or necessary. Consults with manager to determine proper course of action such as an independent medical exam.

SPECIALIZED KNOWLEDGE AND/OR SKILL REQUIREMENTS :

1. A minimum of one (1) years of claims adjusting experience in PIP and/or medical claims and demonstrated ability to handle claims of a complicated nature.

2. Must possess on a timely basis all licenses required by the State(s) assigned.

3. Ability to handle claims using the claims on-line system.

4. This is a hybrid role that will require some reporting to the Birmingham Claims office.

Kemper is proud to be an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, disability status or any other status protected by the laws or regulations in the locations where we operate. We are committed to supporting diversity and equality across our organization and we work diligently to maintain a workplace free from discrimination.

Kemper does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Kemper and Kemper will not be obligated to pay a placement fee.