Texas Non-Subscriber Claims Specialist - Remote Opportunity

CCMSI • Dallas, TX, US • 2d ago

Overview

Texas Non-Subscriber Claim Specialist

Location: Fully RemoteSchedule: Monday to Friday, 8:00 AM - 4:30 PMSalary: $80,000 - $90,000

Disclaimer: The posted salary range for this position reflects the anticipated base pay for this role. Actual pay is determined based on factors such as qualifications, skills, relevant experience, internal equity, and location. Additional compensation may include discretionary bonuses, benefits, or other forms of compensation, depending on the role. The salary range provided is in compliance with state and local requirements and is intended to offer transparency to applicants. We encourage open discussions with our hiring team regarding any questions you may have about compensation and benefits for this position.

CCMSI is an Affirmative Action / Equal Employment Opportunity employer offering an excellent benefits package including Medical, Dental, Prescription Drug, Vision, Flexible Spending, Life, ESOP, and 401K. CCMSI conducts background checks in accordance with applicable federal, state, and local laws.

At CCMSI, we seek the best talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we deliver exceptional service to our clients through a culture of integrity, passion, and enthusiasm. Certified as a Great Place to Work, we take pride in providing our employee-owners with rewarding career development opportunities, excellent benefits, and a collaborative work environment.

Why Join CCMSI?

Culture: Our core values emphasize treating employees as valued partners with integrity, passion, and enthusiasm.Career Development: We offer robust training programs, career advancement opportunities, and structured career development pathways.Benefits: Enjoy 4 weeks of paid time off in your first year, 10 paid holidays, and a comprehensive benefits package, including medical, dental, vision, life insurance, 401(k), ESOP, and more.Work Environment: A supportive environment with manageable caseloads and the resources needed to succeed.

About the Role

The Texas Non-Subscriber Claim Specialist is responsible for investigating, evaluating, and adjusting claims for multiple accounts, with a focus on Texas Non-Subscriber claims. This role requires an in-depth understanding of Texas Injury Benefit Plans and associated claims processes.

Responsibilities

Manage Texas Non-Subscriber claims according to Injury Benefit Plans.
Determine claim validity and coverage under the plan.
Work with approved medical providers as outlined in Injury Benefit Plans.
Investigate liability potential and calculate wage replacement benefits.
Draft and issue Benefit Determination Letters, Non-Compliance Warning Letters, and Compliance Letters.
Compose form letters such as disability projections, medical treatment confirmations, and employer communications.
Collaborate with clients and team members to ensure exceptional claim handling.
Potential minimal travel for claim reviews, if requested.

Performance Measures

Adherence to CCMSI Corporate Claims Best Practices, Client Handling Instructions, and Injury Benefit Plans.
Quality and timeliness of claim resolution.
Client satisfaction and communication effectiveness.

Qualifications

Required:

Texas Adjuster License.
Experience with Texas Non-Subscriber claims, including Injury Benefit Plan management.
Expertise in benefit determination, liability investigation, and compliance communications.

Preferred:

AIC, ARM, or CPCU designation.

Skills:

Strong written and verbal communication skills.
Excellent analytical and negotiation abilities.
Detail-oriented with strong organizational skills and the ability to prioritize effectively.
Proficient in Microsoft Office (Word, Excel, Outlook).

Core Values & Principles:

Employees are expected to uphold CCMSI’s Core Values and 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.

If you are an experienced claims professional ready to contribute to a dynamic team and grow your career, apply today to join CCMSI as a Texas Non-Subscriber Claim Specialist!

#RemoteWork #ClaimsSpecialist #TexasNonSubscriber #AdjusterJobs #InsuranceCareers #WorkFromHome #HiringNow #CareerGrowth #CCMSIJobs #JoinOurTeam #CCMSICareers #CCMSITexas #WorkComp #IND123

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