Are You Driven?® We Are.

We are a company of driven, enthusiastic, and determined people. We celebrate achievement and success. We foster innovation, determination, and recognition. Because of that, our employees feel recognized and rewarded for the contributions they make daily. At GAINSCO, it is our people that set us apart.

If you are looking for a place where you can make a difference, perceive how your work impacts the company, and be recognized for your efforts and passion, then GAINSCO is the company for you.

Why Join GAINSCO?

GAINSCO’s work environment rewards engaged individuals who have a desire to contribute and succeed. That’s because our culture encourages individuals to grow their skills as they build their careers. Come join us and become a champion with GAINSCO.

We are seeking a dedicated PIP/Med Pay Claims Representative – First Responder to join our team. In this role, you will be responsible for investigating and resolving First Party Medical claims across multiple states, ensuring compliance with company guidelines and state regulations. This position is ideal for individuals with a background in auto insurance claims adjusting, and who have a keen eye for detail, excellent communication skills, and a passion for providing exceptional customer service.

What does a PIP/MED PAY FIRST RESPONDER do at GAINSCO?

• Conduct thorough investigations, including taking recorded statements, obtaining police reports, repair estimates, and vehicle photos.
• Perform electronic and telephonic investigations, identifying potential indicators for referral to the Special Unit for additional support.
• Assist customers in navigating the 1st Party Medical claims process, providing information on benefits, eligibility, required forms, and procedures.
• Analyze coverage and qualifications based on policy language, statutes, state regulations, and investigation findings.
• Submit recommendations to management for claim approval or denial, ensuring accurate and timely claim resolution.
• Review and respond to correspondence and medical bills in accordance with state regulations and company guidelines, ensuring timely processing.

What is required?

Education:

• High School Diploma or Equivalent
• Bachelor’s degree is preferred

Licenses/ Certifications :

• To perform the essential functions of this job an active Adjuster License will be required to comply with state and GAINSCO requirements.
• Upon hire, additional license(s) may be required. If that is the case, license(s) must be obtained.
• All licenses must be maintained in accordance with state requirements.
• Professional Insurance and/or Claims Designations are a plus.

Experience:

• One or more years of experience in Auto Insurance as a Claims Adjuster required
• Experience with 1st Party Medical Claims Preferred

• Experience with medical coding and/or medical billing a plus

Other skills and abilities:

• Excellent verbal and written communications skills
• Strong attention to detail
• Ability to manage time while prioritizing multiple tasks
• Must be adaptable, analytical and a self-starter
• Ability to remain calm when dealing with difficult customers
• Ability to gather and analyze information to draw independent conclusions and recommendations
• Bilingual (Spanish and English) is preferred

What else do you need to know?

• Remote
• Excellent benefits package: medical & dental (Basic plan FREE), vision insurance, life insurance, short-term and long-term disability insurance.
• Parental Leave Policy
• 401K + Company Match
• PTO Plan + Paid Company determined Holidays.

**Applicants are required to be eligible to lawfully work in the U.S. immediately; employer will not sponsor applicants for U.S. work authorization (e.g. H-1B visa) for this opportunity**

All offers are contingent upon a successful background investigation (including employment, education, criminal and DMV verification- when applicable) and a pre-employment drug test with results satisfactory to GAINSCO.

GAINSCO is an Equal Employment Opportunity Employer