Position Summary
Aegis Security Insurance Company is expanding our automobile insurance footprint into Florida and is seeking an experienced, customer-focused Florida Personal Injury Protection (PIP) Claims Adjuster to join our growing Claims organization.
In this role, you will report to a Claims Supervisor and work closely with medical providers, legal partners, and fellow claims professionals. You will be responsible for investigating, evaluating, negotiating, and resolving Florida Personal Injury Protection (PIP) claims in accordance with Florida statutes, company guidelines, and industry best practices.
This position offers an exciting opportunity to help build Seaview's Florida claims operation from the ground up. As one of the early members of this team, you will help establish best practices, contribute to operational excellence, and deliver exceptional service to our policyholders while supporting the successful expansion of our Florida business.
Location: Phoenix, Arizona (In-Office)
Schedule: Monday-Thursday On-Site and In-Office | Friday Optional Remote
Essential Duties and Responsibilities
Claim Investigation & Coverage Analysis
· Investigate, evaluate, and resolve Florida Personal Injury Protection (PIP) claims from first notice of loss through final disposition.
· Review policy language and determine applicable coverage.
· Conduct thorough investigations by obtaining statements, police reports, medical records, wage documentation, and other supporting evidence.
· Analyze liability, damages, medical treatment, and claim exposure.
· Maintain accurate and timely claim documentation throughout the life of the claim.
Medical Review & Claim Evaluation
· Review medical records, treatment plans, and billing documentation.
· Apply Florida PIP statutes, fee schedules, and reimbursement guidelines.
· Evaluate medical necessity, reasonableness of treatment, and billing accuracy.
· Identify potential fraud indicators, abuse, or questionable billing practices.
· Coordinate with medical review vendors and subject matter experts as appropriate.
Negotiation & Claim Resolution
· Negotiate claim settlements within assigned authority.
· Develop timely and appropriate claim resolution strategies.
· Effectively manage claim severity while maintaining a customer-focused approach.
· Escalate complex claim issues when appropriate.
· Ensure timely payments and proper claim disposition.
Customer Service & Communication
· Build positive working relationships with insureds, claimants, attorneys, medical providers, and internal business partners.
· Maintain regular communication throughout the claim process.
· Clearly explain claim decisions, coverage determinations, and settlement outcomes.
· Deliver exceptional customer service while maintaining professionalism and empathy.
Regulatory Compliance & Quality
· Ensure compliance with Florida insurance regulations, statutory deadlines, and company claim handling standards.
· Maintain quality claim documentation that supports claim decisions.
Qualifications
Required Qualifications
· Minimum of three (3) years of Florida Personal Injury Protection (PIP) claims handling experience.
· Strong knowledge of Florida PIP statutes, regulations, medical terminology, and fee schedules.
· Demonstrated ability to interpret policy language and make sound coverage decisions.
· Experience reviewing medical records, treatment plans, and medical billing.
· Strong negotiation and analytical skills.
· Excellent written and verbal communication skills.
· Strong organizational skills with the ability to manage multiple priorities.
· Ability to work independently while collaborating effectively within a team environment.
Preferred Qualifications
· Bilingual (English/Spanish).
· Florida Adjuster License.
· Prior experience handling litigated PIP claims.
· Experience identifying fraud indicators and working with Special Investigation Unit (SIU) referrals.
· Experience using modern claims management systems.
· Bachelor's degree or equivalent industry experience.
Why Join Aegis Security Insurance Company?
Aegis Security Insurance Company is committed to building a high-performing Claims organization focused on delivering exceptional service to our customers while creating an environment where employees can grow professionally and personally.
As we expand our footprint into Florida, you'll have the unique opportunity to help build a new claims operation, influence best practices, and contribute to the continued success of a growing organization. We believe our greatest competitive advantage is our people, and we invest in their development through collaboration, innovation, and continuous improvement.
We offer:
· Competitive base compensation based on experience, with variable pay potential.
· Comprehensive medical, dental, and vision insurance.
· Company-paid short-term and long-term disability coverage.
· 401(k) with a 5% company match.
· Generous paid time off program.
· Company-sponsored daily lunch program for in-office employees.
· Professional development and career advancement opportunities.
· A collaborative leadership team committed to employee success and continuous improvement.
If you're looking for an opportunity to help build something new while advancing your career with a growing organization, we encourage you to apply.
Pay: $50,000.00 - $65,000.00 per year
Benefits:
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible schedule
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Vision insurance
Application Question(s):
- Do you have Florida PIP experience (must have experience)?
- Do you have a Florida adjuster's license or the ability to obtain?
Work Location: In person
