Overview:
Position Title: Workers’ Compensation Claim Specialist
Location: Lisle, IL
Hours: Monday - Friday, 8:00 AM to 4:30 PM CT
Salary Range: $70,000 - $90,000
Jurisdictions: IL and WI
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.

EDUCATION AND/OR EXPERIENCE

Ten years claims experience is required.
Bachelor degree is preferred.
TX adjusters’ license.

COMPUTER SKILLS

Proficient using Microsof Office products such as Word, Excel, Outlook, etc.

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.)
• Review and maintain personal diary on claim system.
• Assess and monitor subrogation claims for resolution.
• Compute disability rates in accordance with state laws.
• Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
• Performs other duties as assigned

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Work requires the ability to stoop, bend, reach and grab with arms and hands, manual dexterity.
• Work requires the ability to sit or stand up to 7.5 or more hours at a time.
• Work requires sufficient auditory and visual acuity to interact with others