JOB DETAILS

Claim Representative, Medical Only (In Office)

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.

We are seeking a Medical Only Claim Representative to join our team at the Okemos, MI branch. This is an in-office position with no opportunity for remote work. Our office operates Monday through Friday from 8:00 am to 4:30 pm. The role demands exceptional multitasking, time management, and organizational skills in a fast-paced environment.

As a Medical Only Claim Representative, you will be responsible for managing designated medical

only claims and providing support to our claim staff. This position also serves as a training opportunity for potential promotion to an intermediate-level claim position. You must possess self-motivation and strong prioritization abilities to excel in this role.

You will play a critical role in upholding high-quality claim services that meet CCMSI client expectations and corporate claim standards. This position offers a dynamic and challenging work environment for individuals seeking growth and development within the insurance industry.

Responsibilities

Set up and manage medical files only in accordance with corporate claim standards and law.
Establish reserves and/or provide reserve recommendations within established authority levels under direct supervision.
Review and approve related medical and miscellaneous invoices on designated claims. Negotiate any disputed bills/invoices for resolution under direct supervision.
Request and monitor medical treatment of designated claims in accordance with corporate claim standards.
Summarize all correspondence and medical records in claim log notes as well as file same in the appropriate claim.
Close claim files when appropriate.
Retrieve closed claim files and re-file in storage, as requested.
Provide support to claim staff on client service teams.
Compliance with Corporate Claim 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.

Education and/or Experience

Associate Degree or two (2) year's related business experience required

Knowledge of medical terminology preferred.

Computer Skills

Proficient using Microsoft Office products such as Word, Excel, Outlook

Certificates, Licenses, Registrations

none required

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.

#CCMSICareers #CCMSIOkemos #EmployeeOwned #ESOP #GreatPlaceToWork #OkemosMI

#InsuranceCareer #MedicalClaims #ClaimsManagement #CCMSI #ClaimRep #InsuranceJobs

#CareerGrowth #TimeManagement #OrganizationalSkills #Multitasking #ClaimsProcessing

#InsuranceIndustry #ClaimServices #WorkplaceSkills #OfficeLife #IND456

Related Jobs

Customer Service Representative

Best Friends Pet Care • Lansing, MI, USA • 4d ago

Customer Service

Job Details Level : Entry Job Location : Lansing - Lansing, MI Position Type : Full Time... more

4d ago

Apply

Assistant Store Manager

Feeders Pet Supply • Full-time • DeWitt, MI, US • 1w ago

Retail

Feeders Pet Supply is seeking an Assistant Store Manager to join our team. The Assistant Store Manager maintains accurate inventory and sales records and identifies loss areas. Ensures compliance with security, sales... more

1w ago

Apply

Claim Assistant (In Office)

CCMSI • Okemos, MI, US • 2w ago

Administrative Office Assistant

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 ex... more

2w ago

Apply

Workers' Compensation Claim Adjuster (Hybrid) MI Claims

CCMSI • Okemos, MI, US • 1m ago

Finance & Accounting Insurance

1m ago

Apply

Pet Care Store Associate

Feeders Pet Supply • DeWitt, MI, US • 1m ago

Retail

Feeders Pet Supply is currently hiring for a full-time or part-time Pet Care Store Associate to provide excellent customer service to our retail guests. This retail position earns a competitive wage . In add... more

1m ago

Apply

HVAC Outside Sales Account Manager

Dakota Supply Group • Full-time • Lansing, MI, US • 2m ago

Sales Installation & Maintenance

Dakota Supply Group (DSG) is seeking an HVAC Outside Sales Account Manager for our Lansing, MI location. In this full time, salaried plus commissions position, work is typically performed during standard business... more

2m ago

Apply

Dog Groomer

Feeders Pet Supply • Lansing, MI, US • 3m ago

Feeders Pet Supply is calling all compassionate animal lovers to apply to join our amazing animal care team as a full-time OR part-time Dog Groomer. This position earns to to 50% of all commissions. WHY YOU SH... more

3m ago

Apply

Sales Associate

Feeders Pet Supply • Lansing, MI, US • 3m ago

Sales

Feeders Pet Supply is looking to hire a full-time or part-time Sales Associate . Do you have a real desire to do quality work and ensure customer satisfaction? Are you interested in joining a pet care company that... more

3m ago

Apply

Shift Supervisor

Feeders Pet Supply • Lansing, MI, US • 3m ago

Management Supervisor

Feeders Pet Supply is looking to hire a Shift Supervisor to ensure proper care of all animals, provide exceptional customer service, provide direction to team members during their shifts, and so much more! Are you... more

3m ago

Apply

Assistant Store Manager

Feeders Pet Supply • Full-time • Lansing, MI, US • 3m ago

Retail

3m ago

Apply