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CCMSI

TPA for workers' comp and self-insurance

Multi-Line Claim Consultant

Claims AdjudicationConfirmed live in the last 24 hours
Full-timeRemote in USA$65k - $75k

About the Job

Requirements

  • At least 5 years of multi-line claims experience is required.
  • Bachelor's degree is preferred.
  • Proficiency with Microsoft Office programs is required.
  • Excellent oral and written communication skills are required.
  • Initiative to set and achieve performance goals is required.
  • Good analytical and negotiation skills are required.
  • Ability to cope with job pressures in a constantly changing environment is required.
  • Knowledge of all lower-level claim position responsibilities is required.
  • Attention to detail, self-direction, and strong organizational abilities are required.
  • Ability to coordinate and prioritize work is required.
  • Flexibility, accuracy, initiative, and ability to work with minimum supervision are required.
  • Discretion and confidentiality are required.
  • Reliable, predictable attendance within client service hours is required.
  • Ability to respond to internal and external client needs is required.
  • An adjuster's license may be required depending on jurisdiction.

Responsibilities

  • Investigate, evaluate, and adjust multi-line claims in accordance with established claim-handling standards and laws.
  • Establish reserves or provide reserve recommendations within established reserve authority levels.
  • Review, approve, or oversee medical, legal, damage-estimate, and miscellaneous invoices to determine whether they are reasonable and related to designated claims; negotiate disputed bills or invoices for resolution.
  • Authorize and make payments for multi-line claims in accordance with CCMSI claim procedures, industry standards, and established payment authority, using a claim payment program.
  • Negotiate settlements in accordance with Corporate Claim Standards, client-specific handling instructions, and state laws when appropriate.
  • Assist in selecting, referring, and supervising designated multi-line claim files sent to outside vendors, such as legal, surveillance, and case-management vendors.
  • Assess and monitor subrogation claims for resolution.
  • Review and maintain a personal diary in the claim system.
  • Prepare reports detailing claim status, payments, and reserves as requested.
  • Compute disability rates in accordance with state laws.
  • Coordinate communication effectively and promptly with clients, claimants, and appropriate parties throughout the claim-adjustment process.
  • Prepare newsletter articles as requested.
  • Provide notices of qualifying claims to excess and reinsurance carriers.
  • Handle more complex and involved multi-line claims than lower-level claim positions with minimum supervision.
  • Conduct claim reviews or training sessions for designated clients as requested.
  • Attend and participate in hearings, mediations, and informal legal conferences as appropriate.
  • Comply with Corporate Claim Handling Standards and special client handling instructions.
  • Communicate with claimants, employers, or vendors as needed.

Desired Qualifications

  • Bilingual Spanish proficiency is highly valued but not required.
  • Experience handling municipal claims is desirable.

About the Company

CCMSI

TPA for workers' comp and self-insurance

CCMSI provides third-party administration services for workers' compensation and property/casualty self-insurance programs. It manages claims and offers risk management and cost-containment strategies for self-insured entities, including group self-insurance associations. The product works by acting as an administrator for a client’s self-insurance program: handling claims, administering payments, and implementing risk controls and cost-saving measures on a fee basis. CCMSI differentiates itself by focusing on the self-insurance niche and serving organizations that bear their own insurance risks, rather than selling traditional insurance policies. The company’s goal is to help clients reduce claim costs and manage their self-insurance programs more effectively.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Danville, IL
Founded
1978

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