Progressive Spine & Orthopaedics
Personal Injury Protection (PIP) Collections Representative
Progressive Spine & Orthopaedics, Englewood, New Jersey, us, 07631
Personal Injury Protection (PIP) Collections Representative
We are seeking a detail-oriented and organized PIP Representative to join our medical billing team. The ideal candidate will have strong experience in Personal Injury Protection (PIP) insurance and a deep understanding of the claims process for auto accident-related medical billing. This role requires the ability to coordinate effectively between patients, insurance adjusters, and legal professionals to ensure claims are properly submitted, tracked, and reimbursed under PIP coverage.
Key Responsibilities Insurance & Patient Intake
Verify PIP insurance coverage and collect all necessary claim details.
Coordinate with patients, attorneys, and adjusters to obtain documentation such as AOBs, LOPs, and accident reports.
Ensure all intake forms and consents are accurately completed and filed.
Medical Records & Billing
Request, compile, and organize medical records and itemized bills for PIP claims.
Confirm accuracy of CPT and ICD-10 coding for all services rendered.
Submit PIP claims to auto insurers and perform timely follow-ups to ensure payment.
Communication & Coordination
Act as the primary point of contact for insurance companies, attorneys, and patients.
Track and monitor payments, denials, and appeals to maintain up-to-date claim status.
Legal Documentation
Prepare and maintain Letters of Protection (LOPs), Assignments of Benefits (AOBs), and lien documents.
Respond promptly to requests from attorneys and insurance carriers for medical records and billing details.
Assist with preparation of final billing summaries for case settlements or litigation proceedings.
Claims Management & Reporting
Maintain detailed PIP tracking logs for all patients, including billed amounts, payments, and outstanding balances.
Submit appeals and corrected claims as needed to ensure proper reimbursement.
Ensure compliance with HIPAA regulations and state-specific PIP laws (particularly NJ & NY).
Qualifications Required:
Minimum 5 years of experience in PIP claims, legal billing, or medical billing.
Strong knowledge of PIP laws and claim procedures (especially for NJ & NY).
Excellent written and verbal communication skills.
Proficient in Microsoft Office and medical billing/EHR systems.
Preferred:
Medical billing or coding certification (CPC, CMRS, etc.).
Experience in chiropractic, orthopedic, or physical therapy settings.
Familiarity with legal documentation and litigation processes related to personal injury.
Work Environment Office-based (Englewood, NJ), standard weekday schedule Monday through Friday 8am–5pm. Occasional overtime may be required to meet claim or settlement deadlines. Collaborative, professional environment supporting multiple providers and specialties.
Pay Transparency Statement In accordance with the New Jersey Pay Transparency Act, this role falls within Pay Grade 7 of the 2025 OPM Salary Table for the NY, NJ, CT, and PA region. Compensation is commensurate with experience and education.
Seniority Level Entry level
Employment Type Full-time
Job Function
Accounting/Auditing and Finance
Industry Medical Practices
#J-18808-Ljbffr
Key Responsibilities Insurance & Patient Intake
Verify PIP insurance coverage and collect all necessary claim details.
Coordinate with patients, attorneys, and adjusters to obtain documentation such as AOBs, LOPs, and accident reports.
Ensure all intake forms and consents are accurately completed and filed.
Medical Records & Billing
Request, compile, and organize medical records and itemized bills for PIP claims.
Confirm accuracy of CPT and ICD-10 coding for all services rendered.
Submit PIP claims to auto insurers and perform timely follow-ups to ensure payment.
Communication & Coordination
Act as the primary point of contact for insurance companies, attorneys, and patients.
Track and monitor payments, denials, and appeals to maintain up-to-date claim status.
Legal Documentation
Prepare and maintain Letters of Protection (LOPs), Assignments of Benefits (AOBs), and lien documents.
Respond promptly to requests from attorneys and insurance carriers for medical records and billing details.
Assist with preparation of final billing summaries for case settlements or litigation proceedings.
Claims Management & Reporting
Maintain detailed PIP tracking logs for all patients, including billed amounts, payments, and outstanding balances.
Submit appeals and corrected claims as needed to ensure proper reimbursement.
Ensure compliance with HIPAA regulations and state-specific PIP laws (particularly NJ & NY).
Qualifications Required:
Minimum 5 years of experience in PIP claims, legal billing, or medical billing.
Strong knowledge of PIP laws and claim procedures (especially for NJ & NY).
Excellent written and verbal communication skills.
Proficient in Microsoft Office and medical billing/EHR systems.
Preferred:
Medical billing or coding certification (CPC, CMRS, etc.).
Experience in chiropractic, orthopedic, or physical therapy settings.
Familiarity with legal documentation and litigation processes related to personal injury.
Work Environment Office-based (Englewood, NJ), standard weekday schedule Monday through Friday 8am–5pm. Occasional overtime may be required to meet claim or settlement deadlines. Collaborative, professional environment supporting multiple providers and specialties.
Pay Transparency Statement In accordance with the New Jersey Pay Transparency Act, this role falls within Pay Grade 7 of the 2025 OPM Salary Table for the NY, NJ, CT, and PA region. Compensation is commensurate with experience and education.
Seniority Level Entry level
Employment Type Full-time
Job Function
Accounting/Auditing and Finance
Industry Medical Practices
#J-18808-Ljbffr