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CCMSI

TPA for workers' comp and self-insurance

Injury and Property Damage Claim Adjuster

Claims AdjudicationUpdated on Nov 10
Full-timeChicago, IL, USA$70k - $80k

About the Job

Requirements

  • At least 5 years of multi-line claim experience is required.
  • Proficiency with Microsoft Office programs is required.
  • An adjuster license may be required depending on jurisdiction.
  • Strong oral and written communication, analytical, negotiation, organizational, coordination, and prioritization abilities are required.
  • The candidate must be detail-oriented, self-starting, discreet, confidential, flexible, accurate, and able to work with minimum supervision.
  • The candidate must be able to manage job pressures in a changing environment and maintain reliable attendance during client service hours.
  • Knowledge of responsibilities associated with lower-level claim positions is required.

Responsibilities

  • Investigate, evaluate, and adjust multi-line claims in accordance with 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 assess whether they are reasonable and related to assigned claims.
  • Negotiate disputed bills and invoices to resolution.
  • Authorize and make multi-line claim payments using the claim payment program, following company procedures and industry standards and remaining within payment authority.
  • Negotiate settlements in accordance with corporate claim standards, client-specific instructions, and state laws, as appropriate.
  • Assist with selecting, referring, and supervising assigned multi-line claim files sent to outside vendors, including legal, surveillance, and case-management vendors.
  • Assess and monitor subrogation claims through resolution.
  • Review and maintain a personal diary in the claim system.
  • Prepare reports on claim status, payments, and reserves as requested.
  • Compute disability rates in accordance with state laws.
  • Coordinate timely communications with clients, claimants, and other appropriate parties throughout claim adjustment.
  • Prepare newsletter articles as requested.
  • 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.
  • Investigate, evaluate, negotiate, and adjust assigned injury, property-damage, commercial auto liability, cargo, and physical-damage claims.
  • Analyze coverage, prepare and issue coverage-position letters, reservation-of-rights letters, and disclaimers, and manage tender situations.
  • Apply knowledge of the MCS-90 endorsement, Carmack Amendment, and Graves Amendment when evaluating liability exposures.
  • Triage cargo and physical-damage claims by severity and complexity and develop handling strategies for timely, accurate, and cost-effective resolution.

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 municipal claims is a plus.

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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