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 skilled Field Adjuster for our Albuquerque, NM location. As a Multi-Line Claim Consultant, you will be responsible for the investigation and adjustment of assigned Multi-Line claims, including desk and field adjustments for sewer backups, power line damages, flooding, and motor vehicle accidents (MVAs). This role operates within the New Mexico jurisdiction, and a valid NM Adjusters license is required.

Our ideal candidate is an experienced field adjuster looking for a dynamic position that offers flex scheduling to balance work and personal life. This position not only requires technical expertise but also demands a high level of service quality as perceived by our clients and adherence to CCMSI’s corporate claim standards. Additionally, this role serves as an advanced training position with the potential for promotion to a more senior level claim position, providing a clear path for career growth and development.

If you are a dedicated professional with a passion for delivering excellent claim services and looking for a rewarding opportunity, we encourage you to apply.

Responsibilities

Investigate, evaluate and adjust multi-line 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 multi-line claims in accordance with CCMSI 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 multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
Assess and monitor subrogation claims for resolution.
Review and maintain personal diary on claim system.
Prepare reports detailing claim status, payments and reserves, as requested.
Compute disability rates in accordance with state laws.
Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
Prepare newsletter articles as requested.
Provide notices of qualifying claims to excess/reinsurance carriers.
Handle more complex and involved multi-line claims than lower level claim positions with minimum supervision.
Conduct claim reviews and/or training sessions for designated clients, as requested.
Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

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+ years multi-line claim experience is required.

Bachelor’s Degree is preferred.

Computer Skills

Proficient with Microsoft Office programs.

Certificates, Licenses, Registrations

Adjusters license may be required based upon jurisdiction.

Physical Demands

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.

Ability to operate an automobile and have a valid driver’s license with a safe driving record
Ability to travel by automobile
Must be able to lift, carry, unfold/extend, and climb a ladder (which may exceed 50 lbs. in weight) that is approved by the appropriate regulatory agency or complies with legislative or regulatory occupational health and safety requirements
Must be able to complete measurements of roofs and inspect interior as necessary including attics, basements, and crawl spaces for residential and commercial structures
Must be able to do the following while conducting an inspection: climb, bend, crawl, stoop, walk, reach, kneel, squat and carry/lift objects (typically weighing less than 50 lbs.)
Requires the ability to occasionally work during non-standard business hours
Requires the ability to work in confined spaces and/or high locations
Must be able to work out of doors in all types of weather
Must be able to walk on adverse/uneven terrains.
Must be able to go up and down multiple flights of stairs.
Must have the ability to be on your feet for extended durations.

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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Senior Field Adjuster with Flex Scheduling - Albuquerque, NM