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.
Join our team as a Workers’ Compensation Claim Adjuster, where you'll play a pivotal role in the investigation and adjustment of assigned workers’ compensation claims. This position offers an opportunity for growth, serving as an advanced training platform for those aspiring towards supervisory or management roles within our organization.
Responsibilities:
- Investigate and adjust assigned workers’ compensation claims efficiently and effectively.
- Maintain high standards of quality in workers’ compensation claim services, aligning with CCMSI's corporate claim standards.
- Uphold excellent client perception by delivering top-notch claim services to meet client expectations.
Requirements:
- Possess an AZ Adjusters license, or demonstrate the ability to obtain one within 60 days of hire.
- Previous experience with municipality claims is preferred, providing valuable insight into the nuances of this domain.
- Commitment to a hybrid schedule, requiring presence in the office for two days a week.
Join us in making a difference in the workers’ compensation realm while advancing your career in a supportive and dynamic environment. Apply now to be part of our team!
Responsibilities
- Review, assign and provide supervision of all claim activity for designated claims to ensure compliance with Corporate Claim Standards, client specific handling instructions and in accordance with applicable laws.
- Investigate, evaluate and adjust assigned claims in accordance with established claim handling standards and laws.
- Reserve establishment and/or oversight of reserves for designated claims within established reserve authority levels.
- 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 designated claim staff in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
- Direct handling of designated litigated and complex claims.
- Responsible for client satisfaction.
- Supervision of all claim activity for specified accounts.
- Attend account Board Meetings, conduct file review meetings and/or training sessions with clients, as requested.
- Performance appraisals and objective/goal setting and attainment of claim staff.
- Develop revise and implement workflow processes to ensure efficiencies and provide oversight of individual caseloads, as appropriate.
- Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
- Performs other duties as assigned.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- 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.
Education and/or Experience
5+ Yeas of AZ Workers' Compensation Claim Adjusting Experience
Computer Skills
Proficient using Microsoft Office products such as Word, Excel, Outlook, etc.
Certificates, Licenses, Registrations
Must have an AZ adjusters license, or the ability to obtain within the first 60 days of hire
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.
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