Multi-Line Claim Representative II

4 weeks ago

Englewood, United States CCMSI Full time

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.

Are you an experienced claims professional with a passion for general liability claims? CCMSI is seeking a dedicated Multi-Line Liability Claim Representative II to join our team. This role is essential in managing and adjusting complex general liability claims, offering a robust platform for professional growth and advancement within our organization.

As a Multi-Line Liability Claim Representative II, you will:

  • Manage General Liability Claims: Investigate and adjust general liability claims, ensuring thorough handling in line with CCMSIs guidelines and industry standards.
  • Review and Resolve: Examine medical, legal, and miscellaneous invoices related to general liability claims, negotiating disputed bills to reach fair resolutions.
  • Authorize Payments: Oversee and authorize claim payments, using our claim payment program in adherence to industry standards and within your settlement authority.
  • Negotiate Settlements: Engage with claimants and attorneys to negotiate settlements as per client authorizations.
  • Supervise Defense: Assist in the selection and management of defense attorneys for general liability cases.
  • Monitor Subrogation: Assess and monitor subrogation claims to ensure proper resolution.
  • Report Preparation: Prepare detailed reports on general liability claims, payments, and reserves, and provide necessary reports for excess insurers.
  • Maintain Compliance: Adhere to service commitments and deliver high-quality claim service to clients.
Responsibilities:
  • Investigate and adjust multi-line liability claims in accordance with established claims handling procedures using CCMSI guidelines and direct supervision.
  • Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing liability claims. Negotiate any disputed bills for resolution.
  • Authorize and make payment of liability claims utilizing a claim payment program in accordance with industry standards and within settlement authority.
  • Negotiate settlements with claimants and attorneys in accordance with client's authorization.
  • Assist in selection and supervision of defense attorneys.
  • Assess and monitor subrogation claims for resolution.
  • Prepare reports detailing claims, payments and reserves.
  • Provide reports and monitor files, as required by excess insurers.
  • Compliance with Service Commitments as established by team.
  • Delivery of quality claim service to clients.
  • 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.
  • Individual must be a self-starter with strong organizational abilities.
  • Ability to coordinate and prioritize required.
  • Flexibility, initiative, and the ability to work with a minimum of direct supervision a must.
  • Discretion and confidentiality required.
  • Ability to work as a team member in a rapidly changing environment.
  • 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

Level II Claim Rep will possess excellent claims management skills, typically with 5 to 10 years of experience or equivalent education, along with proven claims handling performance levels.

Computer Skills

Proficient with Microsoft Office programs such as: Word, Excel, Outlook, etc.

Certificates, Licenses, Registrations

Adjusters license is required.

CA/CO/TX and AZ general liability claims experience is highly preferred.

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 #CCMSIWesternLiability #EmployeeOwned #ESOP #RemoteJobs #WorkFromHome #RemoteWork #NationwideHiring #Telecommute #WorkAnywhere

#VirtualWork #ClaimsAdjuster #MultiLineClaims #CareerGrowth #RemoteOpportunity

#InsuranceJobs #JobOpening #Adjusters #InsuranceCareers #CareerAdvancement

#FlexibleWork #WorkLifeBalance #RemoteCareer #IND123

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