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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-timeChicago, IL, USA

About the Job

Requirements

  • At least 5 years of multi-line claim experience.
  • Excellent oral and written communication skills, analytic and negotiation skills, detail orientation, organizational abilities, and the ability to coordinate and prioritize work.
  • Knowledge of responsibilities associated with lower-level claim positions, and the ability to work with minimum supervision in a changing environment.
  • Discretion and confidentiality, reliable attendance during client service hours, responsiveness to internal and external client needs, and flexibility and accuracy.
  • Proficiency with Microsoft Office programs.
  • An adjuster license may be required depending on jurisdiction.

Responsibilities

  • Investigate, evaluate, and adjust multi-line claims in accordance with established claim handling standards and applicable laws.
  • Establish reserves or provide reserve recommendations within established authority levels.
  • Review, approve, or oversee medical, legal, damage-estimate, and miscellaneous invoices to determine whether they are reasonable and related to assigned claims; negotiate disputed bills or invoices for resolution.
  • Authorize and make multi-line claim payments in accordance with claim procedures, industry standards, and established payment authority.
  • Negotiate settlements in accordance with corporate claim standards, client-specific handling instructions, and state laws, when appropriate.
  • Assist with selecting and referring designated multi-line claim files to outside vendors, and supervise those files.
  • Assess and monitor subrogation claims for resolution; maintain a personal diary in the claim system; and prepare reports detailing claim status, payments, and reserves as requested.
  • Compute disability rates in accordance with state laws and coordinate timely communications with clients, claimants, and other appropriate parties throughout the claim adjustment process.
  • Prepare newsletter articles as requested and provide notices of qualifying claims to excess or reinsurance carriers.
  • Handle more complex 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.

Desired Qualifications

  • A Bachelor's Degree is preferred.
  • Bilingual Spanish proficiency is highly valued for communicating with claimants, employers, or vendors, but is not required.
  • Experience handling elevator claims.

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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