Workers' Compensation Claim Adjuster
Company: Ccmsi
Location: Las Vegas
Posted on: May 2, 2024
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Job Description:
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.The Workers' Compensation Claim Consultant 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.Responsibilities: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.Qualifications:Education and/or ExperienceFive
or more years claims experience is required.Bachelor degree is
preferred.Computer SkillsProficient using MicroSoft Office products
such as Word, Excel, Outlook, etc.Certificates, Licenses,
RegistrationsAdjuster's license may be required based upon
jurisdictionPhysical DemandsThe 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.Object Handling
CategoriesWork requires the ability to lift/carry objects routinely
as follows:Light Lifting: No lifting of objects weighing more than
15 pounds on a regular basis.Other Physical DemandsWork requires
the ability to stoop, bend, reach and grab with arms and hands,
manual dexterity.Work requires the ability to sit or stand up to
7.5 or more hours at a time.Work requires sufficient auditory and
visual acuity to interact with others.CORE VALUES &
PRINCIPLESResponsible 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.by Jobble
Keywords: Ccmsi, Paradise , Workers' Compensation Claim Adjuster, Other , Las Vegas, Nevada
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