PIP Claims Examiner II

GEICO is seeking a PIP Examiner II to handle complex Personal Injury Protection claims in our Finance & Insurance operations. In this role, you will investigate, evaluate, and resolve PIP claims from first notice through settlement, ensuring accurate coverage decisions, cost-effective outcomes, and strong regulatory compliance. You will review medical records and bills, assess liability and compensability, negotiate with claimants, attorneys, and providers, and collaborate with legal and SIU teams on disputed or suspicious claims. GEICO offers robust training, performance-driven culture, and clear paths for advancement in claims and insurance expertise.

Responsibilities

• Investigate and evaluate complex PIP claims from first notice through resolution.

• Review coverage, medical records, and bills to determine compensability and appropriate payments.

• Negotiate settlements with claimants, attorneys, and providers within authority limits.

• Ensure compliance with state PIP/No-Fault regulations and internal GEICO guidelines.

• Document claim files clearly and accurately in claims management systems.

• Collaborate with legal, SIU, and medical review resources on disputed or suspected fraud claims.

• Manage a high-volume caseload while meeting quality, timeliness, and customer service metrics.

• Communicate clearly with policyholders, claimants, and internal partners regarding claim status and decisions.

Required Skills

• PIP claims handling

• Insurance policy interpretation

• Medical billing review

• Liability evaluation

• Negotiation

• Litigation coordination

• Claims management systems (e.g., Guidewire)

• Regulatory compliance (PIP/No-Fault)

• Data analysis & reporting

• Written documentation