Workers' Compensation Claim Adjuster
2 weeks ago
Overview:
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:
- 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.
The Workers' Compensation Claim Consultantis responsible for investigating and adjusting assigned claims, specifically within the jurisdictions of Florida, South Carolina, Georgia, and North Carolina. This role involves handling multiple client accounts and requires a minimum of 5 years of experience in adjusting lost time workers' compensation claims in Florida. After an initial training period, this position allows for a hybrid work arrangement, with two days in the office per month. It may also serve as an advanced training position with potential for promotion to a more senior claim role. The consultant is accountable for delivering high-quality claim services that meet CCMSI's corporate standards and client expectations. The ideal candidate will be driven by service and quality.
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.
- Performs other duties as assigned.
Qualifications:
Education and/or Experience
Five or more years claims experience is required.
Computer Skills
Proficient using MicroSoft Office products such as Word, Excel, Outlook, etc.
Certificates, Licenses, Registrations
FL, GA, SC or NC adjusters license is required.
CORE VALUES & PRINCIPLES
Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.
CCMSI is an Affirmative Action/Equal Employment Opportunity employer offering an excellent benefit package included Medical, Dental, Vision, Prescription Drug, Flexible Spending, Life, ESOP and 401K.
#CCMSICareers #CCMSIMaitland #EmployeeOwned #GreatPlaceToWork #ESOP
#WorkersCompensation #ClaimsConsultant #HybridWork #InsuranceCareers #WorkersCompClaims #FLJobs #SoutheastJobs #ClaimsAdjuster #InsuranceIndustry #CareerGrowth #RemoteWork #JobOpening #ClaimsSpecialist #InsuranceJobs #JobOpportunity #FLWorkComp #WorkCompClaims #IND123
-
Workers Compensation Claims Adjuster III
3 weeks ago
Maitland, United States AmTrust Financial Full timeOverview: AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Claims Adjuster III - WC. The adjuster is responsible for the prompt and efficient examination, investigation, settlement or declination of workers compensation insurance claims through effective research, negotiation and interaction with insures,...
-
Workers Compensation Claims Adjuster II
4 weeks ago
Maitland, United States AmTrust Financial Full timeOverview: The Workers' Compensation Adjuster II is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. Maintains a solid understanding of AmTrusts mission, vision, and values. Upholds the...
-
Workers' Compensation Claim Adjuster
3 months ago
Maitland, United States CCMSI Full timeOverview: 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,...
-
Workers Compensation Claims Manager
2 months ago
Maitland, United States AmTrust Financial Services, Inc. Full timeOverviewAmtrust Financial Services, a fast growing commercial insurance company, has a need for a Workers’ Compensation Claims Supervisor. The WC Claims Supervisor works with the Claim Adjusters to manage and ensure the Workers' Compensation claims activities are being handled within the Amtrust Best Practices, develop and maintain professional customer...
-
Workers Compensation Claims Manager
2 months ago
Maitland, United States AmTrust Financial Services, Inc. Full timeOverviewAmtrust Financial Services, a fast growing commercial insurance company, has a need for a Workers’ Compensation Claims Supervisor. The WC Claims Supervisor works with the Claim Adjusters to manage and ensure the Workers' Compensation claims activities are being handled within the Amtrust Best Practices, develop and maintain professional customer...
-
Workers Compensation Manager, Claims
2 weeks ago
Maitland, United States AmTrust Financial Full timeOverview: Amtrust Financial Services, a fast growing commercial insurance company, has a need for a Workers Compensation Claims Supervisor. The WC Claims Supervisor works with the Claim Adjusters to manage and ensure the Workers' Compensation claims activities are being handled within the Amtrust Best Practices, develop and maintain professional customer and...
-
Workers Compensation Manager, Claims
5 days ago
Maitland, United States AmTrust Financial Full timeOverview: Amtrust Financial Services, a fast growing commercial insurance company, has a need for a Workers Compensation Claims Supervisor. The WC Claims Supervisor works with the Claim Adjusters to manage and ensure the Workers' Compensation claims activities are being handled within the Amtrust Best Practices, develop and maintain professional customer and...
-
Claims Supervisor
5 days ago
Maitland, Florida, United States AmTrust Financial Full timeJob SummaryAmTrust Financial Services is seeking a highly skilled Workers Compensation Claims Supervisor to join our team. As a key member of our claims department, you will be responsible for managing and ensuring the effective handling of Workers Compensation claims activities within our organization.Key ResponsibilitiesDevelop and implement short-range...
-
Workers Compensation Claims Manager
5 days ago
Maitland, Florida, United States AmTrust Financial Full timeJob SummaryAmTrust Financial Services is seeking a highly skilled Workers Compensation Claims Supervisor to join our team. As a key member of our claims department, you will be responsible for managing and ensuring the effective handling of Workers Compensation claims activities within our organization.Key Responsibilities• Develop and implement...
-
Workers' Compensation Claims Manager
2 months ago
Maitland, United States CCMSI Full timeOverview: 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,...
-
Workers Compensation Claims Team Lead
5 days ago
Maitland, Florida, United States AmTrust Financial Full timeJob SummaryAmTrust Financial Services is seeking a highly skilled Workers Compensation Claims Supervisor to join our team. As a key member of our claims department, you will be responsible for managing and ensuring the effective handling of Workers Compensation claims activities within our organization.Key ResponsibilitiesDevelop and implement short-range...
-
Claims Examiner III
2 days ago
Maitland, Florida, United States AmTrust Financial Services, Inc. Full timeJob SummaryAmTrust Financial Services, Inc. is seeking a highly skilled Claims Examiner III to join our team. As a Claims Examiner III, you will be responsible for examining, investigating, and settling workers' compensation insurance claims in a prompt and efficient manner.Key ResponsibilitiesConduct thorough investigations of workers' compensation claims,...
-
Insurance Claims Adjuster I
4 days ago
Maitland, Florida, United States AmTrust Financial Services, Inc. Full timeJob SummaryAmTrust Financial Services, Inc. is seeking a highly skilled Claims Examiner I to join our team. As a Claims Examiner I, you will be responsible for conducting thorough investigations and evaluations of insurance claims to ensure accurate and timely resolutions.Key ResponsibilitiesConduct prompt and independent reviews of insurance claims to...
-
Logistics Claims Administrator
2 weeks ago
Maitland, Florida, United States Armada Full timePosition OverviewThis role is pivotal within Armada, focusing on the management of invoice discrepancies from initial identification to final resolution. The Claims Coordinator will serve as the primary liaison among Distribution Centers, suppliers, and carriers, ensuring thorough investigation and resolution of claims.Key ResponsibilitiesAct as the initial...
-
Claims Management Trainee
2 weeks ago
Maitland, Florida, United States Progressive Insurance Full timeJob Overview - Medical Claims Processing AssociateAs a Medical Claims Processing Associate, you will play a crucial role in ensuring the efficiency and effectiveness of the medical claims process for our clients.Your primary focus will be on personal injury protection medical coverage, where you will evaluate accident details, medical documentation, and...
-
Claims Coordinator
1 month ago
Maitland, United States Armada Full timeThis position is for ATEC Logistics, LLC, a subsidiary of Armada. Founded in 1989 and based in Maitland, Florida, ATEC (www.atecsystems.com) is a logistics provider with expertise in the areas of global ocean shipping, export documentation, and order management services. SUMMARY The overall responsibility of this position is to be the point of contact in all...
-
Construction Defect
2 weeks ago
Maitland, United States CCMSI Full timeOverview 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,...
-
Litigated Claims Expert II, General Liability
2 weeks ago
Maitland, Florida, United States Zurich Insurance Company Ltd. Full timeElevate Your Career with Zurich North America Claims:Join us as a Litigated Claims Expert at Zurich North America Claims, where we prioritize work-life balance and flexibility in your career journey. Our hybrid work model is designed with our employees' needs at the forefront, providing an ideal mix of flexibility and teamwork. You will have the autonomy to...
-
Maitland, Florida, United States Zurich Insurance Company Ltd. Full timeElevate Your Career with Zurich North America Claims:Join Zurich North America Claims as a Senior Litigation Claims Analyst, where we prioritize work-life balance and flexibility in your career journey. Our hybrid work model is designed to meet the diverse needs of our employees, providing an ideal mix of independence and teamwork. You will have the...
-
Complex Claims Team Lead, Liability Division
5 days ago
Maitland, Florida, United States AmTrust Financial Full timeAbout the RoleWe are seeking a highly experienced and skilled Senior Claims Manager to lead our General Liability team. As a key member of our Claims Department, you will be responsible for overseeing the handling of complex commercial liability claims and developing a high-performing team of claims professionals.Key ResponsibilitiesTeam Leadership: Own the...