Workers' Compensation Senior Claim Specialist
Workers' Compensation Senior Claim Specialist
Cannon Cochran Management Services, Inc. (CCMSI)
Cannon Cochran Management Services, Inc. (CCMSI) is a leading Third Party Administrator in self-insurance services headquartered in Danville, IL. We are guided by core values including integrity, insisting on excellence and being passionately focused on customer service. Those values, coupled with our Employee Stock Ownership Plan (ESOP), engage ownership with our employees and offers top of the line customer service for both our internal and external clients.
This is a perfect opportunity to work in a growing, dynamic work environment. CCMSI’s emphasis is on customer service and you will be expected to set and achieve performance goals in a challenging and growing team environment.
The Workers' Compensation Senior Claim Specialist is responsible for the investigation and adjustment of assigned claims. This position may be used as an advanced training position for consideration for promotion to a supervisory/management 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.
- Compute disability rates in accordance with state laws.
- Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
- Provide notices of qualifying claims to excess/reinsurance carriers.
- Handle more complex and involved claims than intermediate/lower level claims positions with minimum supervision, as requested.
- Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
- Supervision of all claim activity for specified accounts.
- Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
- Performs other duties as assigned.
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 claim experience is required.
- Bachelor Degree is preferred.
- Proficient using Microsoft Office programs such as Word, Excel, Outlook, etc.
Certificates, Licenses, Registrations
- AIC Designation preferred.
- 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.
Object Handling Categories
- Work 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.
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.
Contact: Please apply at www.ccmsi.com/careers
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