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Experienced Claims Resolution Specialist

2 months ago

Chicago, Illinois, United States SCI Summit Consulting, LLC Full time

Company Overview

SCI Summit Consulting, LLC is a prominent organization dedicated to providing comprehensive workers' compensation solutions across the Southeast. With a strong workforce and a commitment to employee development, we foster an environment that promotes growth and expertise in the field of claims management.

Role Overview

As a Senior Claims Specialist, you will play a pivotal role in managing and resolving complex claims. Your expertise in workers' compensation will be essential in delivering exceptional service to our clients while ensuring compliance with all relevant regulations.

Key Responsibilities

  • Conduct thorough investigations and evaluations of claims, assessing coverage and liability.
  • Gather and analyze necessary documentation, including reports and statements, to support the claims process.
  • Facilitate the resolution of claims, participating in arbitrations, mediations, and depositions as required.
  • Make informed recommendations regarding settlements and reserves, collaborating with supervisors on cases that exceed personal authority.
  • Communicate complex information effectively to all stakeholders, maintaining professionalism at all times.
  • Ensure timely and accurate processing of claims payments.
  • Adhere to all legal requirements and company policies throughout the claims handling process.
  • Provide mentorship and technical guidance to junior staff and other departments.
  • Contribute to talent selection and performance management processes for direct reports.
  • Perform additional duties as assigned.

Job Requirements

Education: Bachelor's Degree or equivalent experience in a relevant field.

Experience: A minimum of 10 years of related experience in claims management or a similar role.

Benefits: We offer a competitive Total Rewards package, including medical, dental, vision, paid time off, and a 401(k) plan for eligible employees.

For more information about our benefits and compensation structure, please consult with your recruiter during the hiring process.