Claim Representative; Medical

Claim Representative (Medical Only) page is loaded## Claim Representative (Medical Only) locations:
Gainesville, GA (USA) time type:
Full time posted on:
Posted Yesterday job requisition :
R8520

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.
Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.
Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise.

At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.
** Essential Job Functions and Responsibilities
*** Manages an inventory of claims to evaluate compensability/liability.
* Conducts claim investigations to confirm coverage and to determine liability, compensability and damages.
* Determines and may negotiate appropriate claim settlements/reserves within prescribed authority. May attend arbitrations, mediations, depositions, or trials.
* Conveys routine to moderately complex information regarding coverage and settlements to insureds, claimants, and external partners.
* May authorize payments in accordance with assigned authority limit and ensures payments are made in a timely manner.
* Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements.
* Performs other duties as assigned.
* The person hired for this position will work out of the Gainesville, GA office which offers a hybrid work environment. (4 days in office, 1 day remote)  #LI-Hybrid
** Job Requirements**###
*
* Education:

** Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field or equivalent experience.### ###
*
* Experience:

** Generally, a minimum of 6 months of experience in property and casualty claims handling. Completion of or continuing progress toward a professional designation preferred, such as Associate in Claims (AIC).###
** Scope of Job/

Qualifications:

** Works within specific limits and authority on assignments of moderate technical complexity and coordination. Demonstrates functional analytical, negotiation, and problem-solving skills. Demonstrates knowledge of insurance policies, coverage, and claims handling procedures. Develops and maintains knowledge of industry laws and regulations. Demonstrates ability to organize and prioritize caseloads, ensuring timely resolution of claims. Strong interpersonal and communication skills with the ability to build relationships and handle negotiations.

Proven ability to handle confidential information with discretion.

This job is non-exempt in California and Washington
** Company:
** SCI Summit Consulting, LLC
** Benefits:
** We offer competitive benefits packages for full-time and part-time employees . Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits. Compensation varies by role, level, and location and is influenced by skills, experience, and business needs.

Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at .
** Excludes seasonal employees and interns.
** Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees. With more than 40 years of experience, Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.

Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise.
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