Multi-Line Claim Consultant

Multi-Line Claim Consultant

Position Title:

Multi-Line Claim Consultant

Location:

Hybrid-Reporting to Chicago, IL Region

Chicago-area candidates preferred. Remote eligible;
This role may be performed in states where CCMSI is authorized to hire. Pay transparency requirements are met for applicable jurisdictions.

Schedule:

8:00 am-4:30 pm CT

Salary Range: $70,000-$80,000

The Multi-Line Claim Consultant position is responsible for the investigation and adjustment of assigned Multi-Line claims. This position may be used as an advanced training position for consideration of a promotion to a more senior level claim position. The Multi-Line Claim Consultant is accountable for the quality of claim services as perceived by CCMSI clients and within our corporate claim standards.

This is a full life?cycle ML adjuster position within a TPA environment, and only candidates with proven Multi Line claims experience will be considered.

• 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.

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.

Nice to Have:

• Bilingual (Spanish) proficiency highly valued for communicating with claimants, employers, or vendors, but not required.

Why You'll Love Working Here

• 4 weeks (Paid time off that accrues throughout the…