Workers' Compensation Claim Adjuster

3 weeks ago

Reading, 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.

We are seeking a Workers' Compensation Claim Consultant for a hybrid position, with 2 days per week remote and 3 days in-office following a 60-day training period. Applicants must hold a MA, CT, and/or RI adjusters license. Fluency in Spanish (reading, writing, speaking) is a strong asset.

The Workers' Compensation Claim Consultant will conduct investigations and manage assigned claims. This role may serve as advanced training for potential promotion to a senior-level claims position. Responsibilities include ensuring the quality of claims services meets CCMSI client expectations and corporate standards.

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

MA, CT and/or RI 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 #CCMSI #ESOP #EmployeeOwned #GreatPlaceToWorkCertified #WorkLifeBalance

#WorkersCompensation #ClaimsAdjuster #InsuranceClaims #HybridWork #RemoteWork

#CareerDevelopment #InsuranceIndustry #BilingualProfessionals #ClaimsManagement

#ProfessionalDevelopment #BilingualAdjusters #ReadingMA #MassachusettsJobs #BostonJobs

#NewEnglandJobs #NewEnglandWorkComp #NewEnglandClaims #IND123

  • Workers' Compensation Claim Adjuster

    3 weeks ago

    Reading, Massachusetts, 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,...

  • Workers' Compensation Claim Manager

    2 weeks ago

    Reading, Pennsylvania, United States Cannon Cochran Management Services, Inc. (CCMSI) Full time

    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...

  • Workers' Compensation Claim Supervisor Technical

    3 days ago

    Reading, 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,...

  • Workers' Compensation Claim Manager

    3 weeks ago

    Reading, 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,...

  • Workers' Compensation Claim Supervisor Technical

    3 weeks ago

    Reading, Massachusetts, 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,...

  • Workers' Compensation Claim Manager

    3 days ago

    Reading, 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,...

  • Workers' Compensation Claim Manager

    4 weeks ago

    Reading, Massachusetts, 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,...

  • Multi-line Claim Adjuster

    4 weeks ago

    Reading, 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...

  • Multi-Line Claim Adjuster

    4 weeks ago

    Reading, Massachusetts, 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,...

  • Claim Quality Review Consultant

    3 weeks ago

    Reading, United States CNA Full time

    You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. Under technical direction, conducts on-site Claim audits, monitors...

  • Youth Care Worker

    2 weeks ago

    Reading, United States The Childrens Home of Reading Youth & Family Services Full time

    Job DescriptionJob DescriptionThe Children's Home of Reading Youth & Family Services, located at 1010 Centre Ave, Reading, PA, is seeking Full-Time Youth Care Workers to cover various staffing schedules. We are specifically looking to cover our 2nd Shift (2PM-10PM) schedule with limited availability in 1st (6AM-2PM) & 3rd Shift (10PM-6AM).Position...

  • Food Service Worker

    6 days ago

    Reading, United States Sodexo S A Full time

    Job Description Location Name: HAVEN BEHAVIORAL HOSPITAL OF EASTERN PENNSYLVANIA - 54746001 Location ID: 54746001 Location: HAVEN BEHAVIORAL HOSPITAL OF EASTERN PENNSYLVANIA - 54746001 Working with Sodexo is more than a job; it's a chance to be part of something greater. You'll belong in a company and team that values you for you; you'll act with purpose...

  • Youth Care Worker

    1 week ago

    Reading, United States The Childrens Home of Reading Youth & Family Services Full time

    The Children's Home of Reading Youth & Family Services, located at 1010 Centre Ave, Reading, PA, is seeking Full-Time Youth Care Workers to cover various staffing schedules. We are specifically looking to cover our 2nd Shift (2PM-10PM) schedule with limited availability in 1st (6AM-2PM) & 3rd Shift (10PM-6AM).Position Requirements: Must be at least 21 Years...

  • Youth Care Worker

    2 weeks ago

    Reading, United States APIS Services Inc Full time

    The Children's Home of Reading Youth & Family Services, located at 1010 Centre Ave, Reading, PA, is seeking Full-Time Youth Care Workers to cover various staffing schedules. We are specifically looking to cover our 2nd Shift (2PM-10PM) schedule with limited availability in 1st (6AM-2PM) & 3rd Shift (10PM-6AM).Position Requirements: Must be at least 21 Years...

  • Insurance Follow-Up Representative

    2 weeks ago

    Reading, United States Annuity Health Full time

    Job DescriptionJob DescriptionDescription:The Insurance Follow-Up Representative will be responsible for all collection functions for hospital and physician services. This primary responsibility of this position is account resolution which includes the following duties: reviewing accounts, following up with insurance companies on claim status, gathering and...

  • Remote Insurance Follow-Up Representative

    3 weeks ago

    Reading, United States Annuity Health Full time

    Job DescriptionJob DescriptionDescription:A Remote Insurance Follow-Up Representative will be responsible for all collection functions for hospital and physician services. This primary responsibility of this position is account resolution which includes the following duties: reviewing accounts, following up with insurance companies on claim status, gathering...

  • Full-Time Youth Care Workers

    5 days ago

    Reading, United States The Children’s Home of Reading Full time

    The Children's Home of Reading Youth & Family Services, located at 1010 Centre Ave, Reading, PA, is seeking Full-Time Youth Care Workers to cover various staffing schedules. We are specifically looking to cover our 2nd Shift (2PM-10PM) schedule with limited availability in 1st (6AM-2PM) & 3rd Shift (10PM-6AM). Position Requirements: Must be at least 21...

  • Remote Insurance Follow-Up Representative

    2 weeks ago

    Reading, United States Annuity Health Full time

    Job DescriptionJob DescriptionDescription:A Remote Insurance Follow-Up Representative (MediCal) will be responsible for all collection functions for hospital and physician services. This primary responsibility of this position is account resolution which includes the following duties: reviewing accounts, following up with Medi-Cal and various insurance...

  • Roof Technician

    4 weeks ago

    Reading, United States Hancock Claims Consultants Technicians Full time

    Job DescriptionJob DescriptionCLIMB to New Heights…And live the American Dream. Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carriers and adjusters in your area. This is an independent contractor position.We are seeking professional inspectors to join our...

  • HR Generalist-In Person

    1 week ago

    Reading, United States Bear Mountain Health Care Full time

    Bear Mountain Healthcare is seeking an HR Generalist to work in our Long Term Care Nursing facility. The HR Generalist works in the Human Resources department in various aspects. Processing payroll, attendance documentation, new employee on-boarding process which includes, posting for open positions, review of applications, initial interview, offer letters,...