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CCMSI

TPA for workers' comp and self-insurance

Medical Only Clerk Team Supervisor

Claims AdjudicationPosted on Nov 5
Full-timeLisle, IL, USA$70k - $90k

About the Job

Requirements

  • At least five years of claim-handling experience is required.
  • Excellent oral and written communication skills are required.
  • The candidate must be able to set and achieve performance goals and demonstrate analytic and negotiation skills.
  • The candidate must be able to cope with job pressures in a constantly changing environment and know the responsibilities of lower-level claim positions.
  • The candidate must be detail-oriented, self-starting, and strongly organized, and be able to coordinate and prioritize work.
  • The candidate must demonstrate flexibility, accuracy, initiative, discretion, and confidentiality, and be able to work with minimum supervision.
  • Reliable, predictable attendance during client service hours is required.
  • The candidate must be responsive to internal and external client needs.
  • Proficiency with Microsoft Office programs is required.

Responsibilities

  • Review, assign, and supervise claim activity for designated workers' compensation and medical-only claims to ensure compliance with corporate claim standards, client-specific handling instructions, and applicable laws.
  • Train and lead a team of medical-only claim adjusters.
  • Investigate, evaluate, and adjust assigned claims in accordance with established claim-handling standards and laws.
  • Establish and/or oversee reserves for designated claims within established reserve authority levels.
  • Oversee medical bills, damage estimates, and miscellaneous invoices to determine whether they are reasonable and related to designated claims; negotiate disputed bills or invoices for resolution.
  • Authorize and make claim payments using a claim payment program, in accordance with claim procedures, industry standards, and established payment authority.
  • Supervise all claim activity for specified accounts and comply with corporate claim-handling standards and special client handling instructions.
  • Sort daily mail, identify priority mail and checks for immediate action, process incoming checks, and coordinate with Treasury on funding and check printing.
  • Conduct performance appraisals and set objectives and goals for claim and support staff.
  • Conduct monthly check audits.

Desired Qualifications

  • A bachelor's degree is preferred.
  • Three years of supervisory experience is preferred; team-lead experience will be considered.
  • Bilingual Spanish proficiency is highly valued for communicating with claimants, employers, or vendors, but is not required.
  • An AIC certification is preferred.

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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