Kimberly Calarco MBA PMP CPCU ARM AU AIC AINS AIDA

Leads Rating Center, Corporate Operations, Quality Control and Underwriting Assistant Organization under the Underwriting Support & Operations umbrella.

Multi-Line Commercial Underwriting- Small and Core Business Accounts

Multi- Line Commercial Underwriting - Small and Core Business

Handling NJ PIP Medical Management Complex Claims

•Verify and process first party medical payments, medical expense and personal injury protection claims for the Northeast Region specializing in New York according to company policy and No-Fault state regulations and guidelines •Analyze and process medical bills, medical records, medical statements, HICF 1500, UB04 and UB92 forms for injury status and treatment plans; and issue appropriate payment according to company policy and state regulations and guidelines •Contact and negotiate with attorneys, medical providers, first party claimants, employers, adverse carriers and Medicare/Medicaid •Negotiate and settle PIP Litigation matters •Investigate and respond to time demands and disclosure requests; submit necessary reinsurance reports •Identify and submit claims for subrogation; set appropriate claim reserves; orchestrate IME, DME and EUO's as needed •Identify SIU indicators and make referrals; index exposures using ISO •Calculate and issue payment for lost wages, mileage reimbursement, essential services lost and funeral expenses according to company policy and state regulations and guidelines •Special projects include RCS Pending Reduction in the Northeast Region, Value Stream Mapping Bill Review Project, CVO Pending Reduction Project, No-Fault New Hire Re-Build Training Project, AIS Bill Review Project.

•Verify and process first party medical payments, medical expense and personal injury protection claims in 21 states according to company policy and No-Fault state regulations and guidelines •Analyze and process medical bills, medical records, medical statements, HICF 1500, UB04 and UB92 forms for injury status and treatment plans; and issue appropriate payment according to company policy and state regulations and guidelines •Contact and negotiate with attorneys, medical providers, first party claimants, employers, adverse carriers and Medicare/Medicaid •Investigate and respond to time demands and disclosure requests; submit necessary reinsurance reports •Identify and submit claims for subrogation; set appropriate claim reserves; orchestrate IME, DME and Act VI Peer Reviews as needed •Identify SIU indicators; index exposures using ISO •Calculate and issue payment for lost wages, mileage reimbursement, essential services lost and funeral expenses according to company policy and state regulations and guidelines