Personal Injury Protection Claim Adjuster

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 Claim Adjuster PIP to join our Central Claim Operations team located in Buffalo, New York.

The Claim Adjuster PIP will become part of a dedicated claims team focusing on Personal Injury Protection 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, rated A- (Excellent) with a positive outlook by the A.M. Best Company, is proud to be one of Buffalo Business First’s Best Places to Work in Western New York (2023, 2024), a Fast Track company (2019-2024), and a Top Private Company (2019-2024). Merchants has been granted Ward’s 50 designation as a top-performing property-casualty insurance company for four consecutive years. In October 2024, Newsweek and Statista included Merchants Insurance Group on their first-ever America’s Most Reliable Companies list, which highlights organizations that other companies can feel confident doing business with in 2025. Of 1,500 B2B companies evaluated, Merchants was one of only 300 companies to make the list.

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:

• 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 PIP claims involving causal relationship, fee schedule disputes, medical necessity and coverage issues.
• 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.
• Identifying subrogation and/or risk transfer opportunities.

Qualifications & Skills:

• Qualified candidates will have a 4-year degree or equivalent work-related experience.
• A minimum of 1-year claims experience preferably handling personal injury protection claims.
• Professional designations or working towards industry specific designations are a plus.
• Exceptional organization, negotiation, verbal and written communication skills are required.
• Must obtain any required State licensing within 6 months of hire.

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 $50,000 - $66,000.

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

Experience

• 1 year(s): A minimum of 1-year claims experience preferably handling personal injury protection claims.