Reasons you should consider a career with CCMSI:
Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm.- Career development: CCMSI offers robust internships and internal training programs for advancement within our organization.
- Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP.
- Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads.
We are seeking a dedicated Workers' Compensation Senior Claim Specialist to join our team. In this role, you will be responsible for thoroughly investigating and managing assigned claims. This position offers an opportunity for advanced training and potential promotion to a supervisory or management role. Your primary focus will be ensuring the highest quality of claim services, aligning with CCMSI clients' expectations and our corporate claim standards.
This is a hybrid position, allowing flexibility with a combination of in-office work for 2 days per week and remote work for 3 days per week following the initial training period. Additionally, this role involves performing work on our clients site, ensuring direct engagement and support as needed. We highly prefer candidates with an AZ adjuster's license and a minimum of 10 years of experience in Arizona Workers' Compensation Claim Adjusting.
If you are passionate about making a meaningful impact in the field of Workers' Compensation and possess the necessary experience and qualifications, we encourage you to apply and become part of our dynamic team.
- 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.
- Compute disability rates in accordance with state laws.
- Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
- Provide notices of qualifying claims to excess/reinsurance carriers.
- Handle more complex and involved claims than intermediate/lower level claims positions with minimum supervision, as requested.
- Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
- Supervision of all claim activity for specified accounts.
- Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
- Performs other duties as assigned.
Qualifications:
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.
Education and/or Experience
Computer Skills
Certificates, Licenses, Registrations
Physical Demands
- Light Lifting: No lifting of objects weighing more than 15 pounds on a regular basis.
- Work requires the ability to sit or stand up to 7.5 or more hours at a time.
- Work requires sufficient auditory and visual acuity to interact with others
CORE VALUES & PRINCIPLES
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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