CCMSI · 14 hours ago
Multi-Line Claim Consultant
US-FL-Maitland
Full-time
Hybrid
Mid, Senior Level
$80K/yr - $88K/yr
5+ years expCCMSI is a leading Third Party Administrator that partners with global clients to address complex risk management challenges. The Multi-Line Claim Consultant is responsible for investigating and adjusting multi-line claims, ensuring quality service and compliance with corporate standards.
Financial ServicesInsuranceRetail
No H1B
Responsibilities
Investigate, evaluate and adjust multi-line 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 multi-line claims in accordance with CCMSI 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 multi-line 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
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 multi-line 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
FL License required
5+ years multi-line claim experience is required
Excellent oral and written communication skills
Initiative to set and achieve performance goals
Good analytic and negotiation skills
Ability to cope with job pressures in a constantly changing environment
Knowledge of all lower level claim position responsibilities
Must be detail oriented and a self-starter with strong organizational abilities
Ability to coordinate and prioritize required
Flexibility, accuracy, initiative and the ability to work with minimum supervision
Discretion and confidentiality required
Reliable, predictable attendance within client service hours for the performance of this position
Responsive to internal and external client needs
Ability to clearly communicate verbally and/or in writing both internally and externally
Proficient with Microsoft Office programs
Adjusters license required: FL
Preferred
Bachelor's Degree is preferred
Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required
Nice to have: NY license
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
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
Company data provided by crunchbase