Sr. Claim Adjuster Personal Injury Protection at Merchants Insurance Group

Sr. Claim Adjuster Personal Injury Protection (PIP)

Hybrid Work Schedule

Buffalo, NY

Merchants Insurance Group is a leading Property and Casualty Insurer in the Northeast and is looking for a Sr. PIP Claim Adjuster to join our Central Claim Operations team located in Buffalo, New York.

The Sr. PIP Claim Adjuster will become part of a dedicated claims team focusing on litigated and non-litigated PIP claims. This position interacts extensively with internal colleagues as well as policyholders, agents, attorneys and a multitude of claim-related service providers.  

Merchants Insurance Group is proud to be named one of Buffalo Business First’s Best Places to Work in Western New York for a second consecutive year and to be named both a “Fast Track” company and Top Private Company for the sixth consecutive year by Buffalo’s Business First.    Merchants has also been named as one of Ward's top 50 performing insurance companies in the United States for the 4^th year in a row.  Ward's is the provider of benchmarking and best practices for the insurance industry. They analyze staff levels, compensation, business practices and expenses for all areas of company operations.

Merchants offers its colleagues a Hybrid work schedule. The Hybrid work schedule requires 8 full days per month in the office, with the option to work the remaining days at home or in the office. This exciting Hybrid Work benefit offers colleagues a flexible work schedule with the ability to remain connected with their Merchants team and colleagues.

Essential Duties and Responsibilities include, but are not limited to: 

• Evaluating coverage by interpreting/applying policy language to claim facts and preparing appropriate and timely coverage position letters.
• Conducting and directing timely and quality claim investigation, evaluation and equitable settlement of all assigned claims.
• Ensuring timely and accurate reserves consistent with established reserving philosophy and practices.
• Negotiating fair and equitable settlements directly with claimants, medical providers and/or attorneys.
• Identifying subrogation and/or risk transfer opportunities.
• Cultivating relationships with claims and other internal staff, policyholders, attorneys, agents and a variety of service providers and experts all while working towards achieving the most optimal outcomes for Merchants and our policyholders.
• Providing a high level of customer service while managing an inventory of litigated PIP claims involving casual relationship, fee schedule disputes, medical necessity and coverage issues.

Qualifications & Skills:

• Qualified candidates will have a 4-year degree or equivalent work-related experience.
• A minimum of 5 years’ experience handling personal injury protection claims, with a concentration in PIP litigation resolution.
• Professional designations or working towards industry specific designations are a plus. 
• Exceptional organization, negotiation, verbal and written communication skills are required. 
• Experience managing litigated and non-litigated PIP claim issues.
• Ability to oversee and manage defense counsel, select retain appropriate experts and develop appropriate resolution strategies.

Merchants Insurance Group Pay information:

Merchants Insurance Group offers a competitive pay scale.  The actual compensation will be determined based upon experience and other factors permitted by law.  The initial pay range for this position is $57,000 - $82,800.

Merchants Insurance Group Benefits:

• Welcoming and positive work environment.
• Colleague Appreciation events.
• Flexible work arrangements, including flex scheduling and summer hours.
• Hybrid work schedule. The Hybrid work schedule will require 8 full days per month in the office, with the option to work the remaining days per month at home or in the office
• Flexible work arrangements, including flex scheduling and summer hours.
• Competitive pay scale.
• Generous paid time off package.
• Full Benefits: Health, Dental, Vision, Life Insurance, Short Term Disability, 401(k) employer match amount is 100% up to 6% of your annual contributions. You are immediately 100% vested in the employer match dollars.
• Outstanding company bonus program.
• Tuition Reimbursement.

And many more exciting company benefits!! EOE