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Personal Injury Protection (PIP) Liability Claims Risk Manager

Personal Injury Protection (PIP) Liability Claims Risk Manager
This position will report to the Director of Liability Claims and act as the interface between the Company and its Third Party Administrator (TPA) with respect to all matters related to Personal Injury Protection (PIP). This position will be responsible for oversight and guidance of the Third Party Administrator's handling of ABG PIP claims across the United States. The position also requires interaction with internal groups such as SIU, Risk Management, Legal and Financial as well as external vendors. The position requires familiarity with all levels of PIP claims, Including complex claims, which includes fatalities, amputations, traumatic brain injury and other significant injuries, as well as smaller claims. The candidate must be familiar with medical bill review as a claims management tool. The position will be responsible for analyzing metrics, noting trends, how the trends influence the PIP frequency and severity, and providing recommendations based on the analysis. This position will be responsible for applying the contract to losses or seeking appropriate legal opinions.
Monitor TPA's claim handling and take appropriate action if not in line with contracted Client Service Instructions or regulatory guidelines.
Identify changes in PLPD results through review of analytics and investigate reasons for change
Research statutory regulations to ensure compliance as well as regulatory changes. Adjust, train and implement changes to the Client Service Instructions or processes and procedures as necessary
Provide results and resolutions to ABG Leadership, including SLT on all PIP Liability claims
Provide guidance and training to TPA staff on all PIP Liability matters
Bachelor's degree or 10+ years claims experience, or combination. Minimum 5 years PIP claim handling experience, preferably in NY PIP. Minimum 2 years leadership experience in a PIP claims environment.
Familiarity with New York PIP required. Familiarity with Michigan and Florida PIP preferred. Familiarity with Medicare/Medicaid and Child Support Liens required. Ability to identify training needs, as well as develop and deliver training required. Duly licensed to adjust claims in at least one state, with the ability to secure licenses in all states requiring an adjuster license, required. Demonstrated success in identifying fraud, and ability to coordinate with SIU department required. Strong working knowledge of contractual and insurance coverage issues, required. Strong written and verbal communication skills, required. Ability to work with various departments and stakeholders, internally and externally, in person and remotely, required. Proficient in Microsoft Office applications, required. Requires excellent analytical ability, attention to detail, and ability to work independently and in teams. Experience in the automobile rental industry, preferred. Excellent judgment and delivery oriented attitude, required. Self-motivated and have a strong sense of urgency, required. Advanced knowledge and experience with claims system software, document imaging software, and data base management software. Knowledge of insurance process and terms. Strong project management skills. CPCU, AIC or other associated insurance designation preferred. Experience in auditing claim files and providing a rollup of results with feedback and recommendations, required.
Avis Budget Group is a EO employer-Veterans/ Disabled and other protected categories
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