Overview
Join Our Team at CCMSI - Illinois Public Risk Fund
CCMSI is seeking talented individuals to join the Illinois Public Risk Fund, the largest Public Entity Workers’ Compensation pool in Illinois.
About Us:
Illinois Public Risk Fund operates with a dedicated CCMSI claims team of 21 members, housed in our exclusive office space in Lisle, IL. As a leading Third Party Administrator specializing in self-insurance services, we are committed to delivering exceptional service to our clients. CCMSI, an Employee-Owned Company, emphasizes structured career development programs, individual and team recognition, and is Certified as a Great Place To Work with employee satisfaction in the 95th percentile.
Position: Workers' Compensation Claim Advocate I (LevelUP)
Are you interested in launching a rewarding career in insurance claims? Join our LevelUP Career Pathways Program at CCMSI. This role is designed for individuals eager to progress through our structured training program towards becoming a skilled Claim Representative.
Why Choose Claims Adjusting?
- Make a Positive Difference: Support individuals and families in overcoming setbacks and aiding in their recovery and rehabilitation.
- Career Growth Opportunities: Progress from entry-level to leadership roles with endless possibilities.
- Flexible Schedules: Enjoy a hybrid work environment.
- Competitive Compensation and Benefits: Excellent pay and comprehensive benefits package.
As a Claim Advocate I LevelUP, you'll handle the initial phases of claims investigation and evaluation. Under close supervision, you'll focus on non-litigated indemnity cases and contested medical-only claims. Your responsibilities include setting up claim files, coordinating medical treatments, and managing communications with clients and claimants.
Responsibilities
- Investigate, evaluate and adjust medical only claims, contested medical-only claims and handle a maximum of 30 indemnity claims under direct supervision.
- Establish reserves and/or provide reserve recommendations within established authority levels under direct supervision.
- Set up designated claim files and complete all set up instructions, as requested.
- Set up independent medical exams as deemed necessary under direct supervision.
- Request and monitor medical treatment of designated claims in accordance with corporate claim standards.
- Review and approve related medical, legal, damage estimates and miscellaneous invoices on designated claims. Negotiate any disputed bills/invoices for resolution under direct supervision.
- As appropriate, make referrals to outside vendors on designated cases under direct supervision. (i.e., legal surveillance, case management, etc.)
- Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
- Authorize and make payments on claims utilizing a claim payment program in accordance with industry standards and within established authority levels under direct supervision.
- Compute disability rates in accordance with state laws under direct supervision, when appropriate.
- Summarize all correspondence and medical records in claim log notes as well as file same in the appropriate claim.
- Review and maintain personal diary on claim system.
- Provide technical and clerical claims support to designated clients, as requested.
- Compliance with corporate claim standards and special client handling instructions as established.
- Will act as a back-up to designated adjusters when needed.
- 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.
This position is designated for the LevelUP Career Pathway Program which is an internal career pathway position designed to provide training for consideration as a Claim Representative. In order to be successful in this position, the candidate must possess the following skills and attributes:
- An interest in building a career in insurance claims.
- Excellent oral and written communication skills.
- Individual must be a self-starter with strong organizational abilities.
- Proven ability to demonstrate independent critical thinking skills.
- Ability to coordinate and prioritize required with exceptional time management.
- Ability to operate general office equipment and perform clerical duties.
- Flexibility, initiative, and the ability to work with a minimum of direct supervision a must.
- Discretion and confidentiality required.
- Ability to work as a team member in a rapidly changing environment.
- 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
Associate’s degree or two year’s related business experience.
Knowledge of medical terminology preferred.
Commitment and willingness to learn roles with increasing decision making authority and responsibilities.
Computer Skills
Proficient with Microsoft Office programs.
Certificates, Licenses, Registrations
Must pass Adjuster license exam as required for the respective jurisdiction(s).
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 including Medical, Dental, Prescription Drug, Vision, Flexible Spending, Life, ESOP and 401K.
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WHAT YOU'LL DO
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