Overview
Are you looking to launch a rewarding career in insurance claims? Join our LevelUP Career Pathways Program at CCMSI as a Workers' Compensation Claim Associate I (LevelUP).
This role is designed for individuals eager to progress through our structured training program towards becoming a skilled Claim Representative.
Why Choose Claims Adjusting?
What Do Claims Adjusters Do?
At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients.
As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts.
Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile.
Reasons you should consider a career with CCMSI :
Responsibilities
As a Claim Associate I LevelUP , you'll handle the initial phases of claims investigation and evaluation. Under close supervision, you'll focus on non-litigated indemnity cases and contested medical-only claims.
Your responsibilities include setting up claim files, coordinating medical treatments, and managing communications with clients and claimants.
Investigate, evaluate and adjust medical only claims, contested medical-only claims and handle a maximum of 30 indemnity claims under direct supervision.
Establish reserves and / or provide reserve recommendations within established authority levels under direct supervision.
Set up designated claim files and complete all set up instructions, as requested. Set up independent medical exams as deemed necessary under direct supervision.
Request and monitor medical treatment of designated claims in accordance with corporate claim standards. Review and approve related medical, legal, damage estimates and miscellaneous invoices on designated claims.
Negotiate any disputed bills / invoices for resolution under direct supervision. As appropriate, make referrals to outside vendors on designated cases under direct supervision.
legal surveillance, case management, Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
Authorize and make payments on claims utilizing a claim payment program in accordance with industry standards and within established authority levels under direct supervision.
Compute disability rates in accordance with state laws under direct supervision, when appropriate. Summarize all correspondence and medical records in claim log notes as well as file same in the appropriate claim.
Review and maintain personal diary on claim system. Provide technical and clerical claims support to designated clients, as requested.
Compliance with corporate claim standards and special client handling instructions as established. Will act as a back-up to designated adjusters when needed.
Performs other duties as assigned.
Qualifications
This position is designated for the LevelUP Career Pathway Program which is a career pathway position designed to provide training for consideration as a Claim Representative.
In order to be successful in this position, the candidate must possess the following skills and attributes :
Education and / or Experience
Associate’s degree or two year’s related business experience preferred.
Knowledge of medical terminology preferred.
Commitment and willingness to learn roles with increasing decision making authority and responsibilities.
Computer Skills
Proficient with Microsoft Office programs.
Must pass Adjuster license exam as required for the respective jurisdiction(s) within the first 60 days of employment.
CORE VALUES & PRINCIPLES
and leading by example.
CCMSI is an Affirmative Action / Equal Employment Opportunity employer offering an excellent benefit package including Medical, Dental, Prescription Drug, Vision, Flexible Spending, Life, ESOP and 401K.
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TrainingProgram #DanvilleIL #DanvilleJobs #ProfessionalDevelopment #CareerGrowth #InternalTraining
InsuranceCareers #JobOpportunity #SkillDevelopment #CorporateClaimStandards #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #WorkLifeBalance #NowHiring #CareerNotAJob #IND123
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Last updated : 2024-04-28
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