CCMSI · 1 day ago
Workers' Compensation Claim Consultant
Chicago, IL
Full-time
Hybrid
Mid, Senior Level
$65K/yr - $73K/yr
5+ years expCCMSI is a leading Third Party Administrator (TPA) that partners with global clients to provide risk management solutions. The Workers' Compensation Claim Consultant is responsible for investigating and adjusting claims while ensuring compliance with corporate standards and client satisfaction.
Financial ServicesInsuranceRetail
No H1B
Responsibilities
Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws
Establish reserves and/or provide reserve recommendations within established reserve authority levels
Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution
Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority
Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate
Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
Assess and monitor subrogation claims for resolution
Review and maintain personal diary on claim system
Client satisfaction
Prepare reports detailing claim status, payments and reserves, as requested
Compute disability rates in accordance with state laws
Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process
Prepare newsletter articles, as requested
Provide notices of qualifying claims to excess/reinsurance carriers
Handle more complex and involved claims than lower level claim positions with minimum supervision
Conduct claim reviews and/or training sessions for designated clients, as requested
Attend and participate at hearings, mediations, and informal legal conferences, as appropriate
Compliance with Corporate Claim Handling Standards and special client handling instructions as established
Qualification
Required
Five or more years claims experience is required
Bachelor degree is preferred
Preferred
Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required
Benefits
4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
Career growth: Internal training and advancement opportunities
Culture: A supportive, team-based work environment
Company
CCMSI
CCMSI is a third-party administrator for workers' compensation and property/casualty self-insurance programs.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
G
G. Bryan G. Bryan Thomas
President/CEO
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