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, rooted in integrity, passion, and enthusiasm, define how we treat our employees as valued partners.
Career Development: Benefit from robust internships and internal training programs for advancement within our organization.
Comprehensive Benefits: Enjoy a generous benefits package, including 4 weeks paid time off in your first year, 10 paid holidays, and coverage for Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP.
Positive Work Environment: We believe in fostering a workplace where employees find joy in their daily tasks, are equipped with the resources needed, and manage manageable caseloads.

Position Overview: Workers' Compensation Claim Consultant

As a Workers' Compensation Claim Consultant and pivotal member of our team, you'll be responsible for the investigation and adjustment of assigned claims. This role may serve as an advanced training ground for promotion to a more senior claim position. You'll be held accountable for the quality of claim services, aligning with CCMSI clients' expectations and within our corporate claim standards.

Additional Details:

Hybrid/Remote Work: This position offers the flexibility of a hybrid or remote setup for individuals residing in the state of Louisiana.
Specialized Focus: You'll be working on a desk of national accounts with Louisiana workers' compensation claims.
Bilingual Advantage: Proficiency in Spanish is a plus, enhancing your suitability for this role.

If you're seeking a career where your skills are valued, your growth is fostered, and your contributions make a significant impact, CCMSI is the place for you. Join us in shaping the future of self-insurance services while enjoying a positive and rewarding work environment.

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

Investigate, evaluate and adjust 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 claims in accordance with 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 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.
Client satisfaction.
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 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.
Performs other duties as assigned.

Education and/or Experience

Three or more years claims adjusting experience is required.

Computer Skills

Proficient using MicroSoft Office products such as Word, Excel, Outlook, etc.

Certificates, Licenses, Registrations

Adjuster's license preferred

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.

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CCMSI jobs

Workers' Compensation Claim Adjuster (Hybrid or Remote) (Louisiana Claims)