Multi-line Claim Adjuster
1 week 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.
We are seeking a seasoned professional for a remote **Multi-Line Claim Consultant** role, operating within core operational hours of 8 to 4:30pm EST (latest start time at 9am EST). With at least 5 years of experience in Commercial General Liability/Bodily Injury and property damage claims, along with a valid Adjuster license, you'll play a pivotal role in our team.
Your responsibilities will include conducting thorough investigations of Commercial General Liability claims, ranging from moderate to severe complex third-party property damage and bodily injury claims. This entails gathering pertinent information, assessing liability, and determining coverage. Experience with CGL artisan programs on property damage and coverage is a must.
**Responsibilities**:
Conduct through investigation of Commercial General Liability from moderate to severe complex third party property damage and bodily injury claims, including gathering relevant information, assessing liability, and determining coverage.
Ensures timely disposition of all claim in accordance with regulations and statutory requirements
Analyze policy provisions and applicable laws, review lawsuits, tender letter, to prepare coverage and duty to defend analysis.
Interpreter medical records, review medical billing, evaluate claim value and manage claims process to ensure proper resolution.
Review and assess Property Damage estimate, water remediation invoices to ensure they are within the industry standards.
Prepare large loss reports, Reservation of Rights, denial letters, release, tender letters, and all other applicable correspondence.
Within authority granted, recommend appropriate loss, expense and legal reserves with documented rationale, maintaining adequate reserves over the life of the claim reflecting changes in exposure.
Communicate effectively with customers and clients.
Demonstrate technical proficiency through timely, consistent execution of best claims practice and established claims handling guidelines
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. Independent adjusters, experts, defense and coverage counsel, surveillance,etc.)
Assess and monitor risk transfer and subrogation opportunities.
Review and maintain personal diary on claim system.
Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
Provide notices of qualifying claims to excess/reinsurance carriers.
Attend and participate at mediations, and informal legal conferences, as appropriate.
Performs other duties as assigned.
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.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 require
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