Wc Claim Advocate I Levelup - Lisle, United States - CCMSI

CCMSI
CCMSI
Verified Company
Lisle, United States

3 weeks ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

Overview:

Join Our Team at CCMSI - Illinois Public Risk Fund

CCMSI is seeking talented individuals to join the Illinois Public Risk Fund, the largest Public Entity Workers' Compensation pool in Illinois.


About Us:


Illinois Public Risk Fund operates with a dedicated CCMSI claims team of 21 members, housed in our exclusive office space in Lisle, IL.

As a leading Third Party Administrator specializing in self-insurance services, we are committed to delivering exceptional service to our clients.

CCMSI, an Employee-Owned Company, emphasizes structured career development programs, individual and team recognition, and is Certified as a Great Place To Work with employee satisfaction in the 95th percentile.


Position:
Workers' Compensation Claim Advocate I (LevelUP)
Are you interested in launching a rewarding career in insurance claims? Join our LevelUP Career Pathways Program at
CCMSI.

This role is designed for individuals eager to progress through our structured training program towards becoming a skilled Claim Representative.


Why Choose Claims Adjusting?
- **Make a Positive Difference**: Support individuals and families in overcoming setbacks and aiding in their recovery and rehabilitation.
-
Career Growth Opportunities: Progress from entry-level to leadership roles with endless possibilities.
-
Flexible Schedules: Enjoy a hybrid work environment.
-
Competitive Compensation and Benefits: Excellent pay and comprehensive benefits package.

As a
Claim Advocate I LevelUP, you'll handle the initial phases of claims investigation and evaluation. Under close supervision, you'll focus on non-litigated indemnity cases and contested medical-only claims. Your responsibilities include setting up claim files, coordinating medical treatments, and managing communications with clients and claimants.


Responsibilities:


  • Investigate, evaluate and adjust medical only claims, contested medicalonly claims and handle a maximum of 30 indemnity claims under direct supervision.
  • Establish reserves and/or provide reserve recommendations within established authority levels under direct supervision.
  • Set up designated claim files and complete all set up instructions, as requested.
  • Set up independent medical exams as deemed necessary under direct supervision.
  • Request and monitor medical treatment of designated claims in accordance with corporate claim standards.
  • Review and approve related medical, legal, damage estimates and miscellaneous invoices on designated claims. Negotiate any disputed bills/invoices for resolution under direct supervision.
  • As appropriate, make referrals to outside vendors on designated cases under direct supervision. (i.e., legal surveillance, case management, etc.)
  • Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
  • Authorize and make payments on claims utilizing a claim payment program in accordance with industry standards and within established authority levels under direct supervision.
  • Compute disability rates in accordance with state laws under direct supervision, when appropriate.
  • Summarize all correspondence and medical records in claim log notes as well as file same in the appropriate claim.
  • Review and maintain personal diary on claim system.
  • Provide technical and clerical claims support to designated clients, as requested.
  • Compliance with corporate claim standards and special client handling instructions as established.
  • Will act as a backup to designated adjusters when needed.
  • Performs other duties as assigned.

Qualifications:
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.

  • An interest in building a career in insurance claims.
  • Excellent oral and written communication skills.
  • Individual must be a selfstarter with strong organizational abilities.
  • Proven ability to demonstrate independent critical thinking skills.
  • Ability to coordinate and prioritize required with exceptional time management.
  • Ability to operate general office equipment and perform clerical duties.
  • Flexibility, initiative, and the ability to work with a minimum of direct supervision a must.
  • Discretion and confidentiality required.
  • Ability to work as a team member in a rapidly changing environment.
  • 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
Associate's degree or two year's related business experience.

Knowledge of medical terminology preferred.
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