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Multi-Line Claims Adjuster

2 months ago

Metairie Louisiana, United States CCMSI Full time
About CCMSI

CCMSI is a leading Third Party Administrator in self-insurance services, dedicated to 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.

Our Culture

Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm. We believe in creating an environment where employees look forward to coming to work each day, provided with the resources needed to perform effectively and manageable caseloads to maintain high-quality service and job satisfaction.

Job Summary

The Multi-Line Claims Adjuster is responsible for investigating and adjusting assigned Multi-Line claims, including general liability and commercial auto claims. This position may serve as advanced training for potential promotion to a senior-level claim role. The Multi-Line Claims Adjuster is accountable for the quality of claim services, ensuring they meet CCMSI's corporate standards and client expectations.

Key Responsibilities
  • Investigate, evaluate and adjust multi-line 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 multi-line claims in accordance with CCMSI 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 multi-line claim files sent to outside vendors.
  • Assess and monitor subrogation claims for resolution.
  • Review and maintain personal diary on claim system.
  • 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 multi-line 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.
Requirements
  • 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.
Qualifications
  • 5+ years multi-line claim experience is required.
  • Proficient with Microsoft Office programs.
  • Adjusters license is required.