Claim Assistant

Ccmsi•Danville, IL

4d•Hybrid

About The Position

The Claim Assistant provides technical and clerical support to Indemnity Adjusters on designated claims under close supervision. The position is accountable for claim service quality as perceived by CCMSI clients and for compliance with Corporate Claim Standards. It may serve as a training position for consideration of promotion to the claims Level Up program. The role is based in Danville, Illinois, with a full-time Monday–Friday schedule from 8:00 a.m. to 4:30 p.m. Work is hybrid after approximately 60 days of training.

Requirements

Excellent oral and written communication skills.
Self-starter with strong organizational abilities.
Ability to coordinate and prioritize work.
Ability to operate general office equipment and perform clerical duties.
Flexibility, initiative, and ability to work with minimal direct supervision.
Discretion and confidentiality.
Ability to work as a team member in a rapidly changing environment.
Reliable, predictable attendance during client service hours.
Responsiveness to internal and external client needs.
Ability to communicate clearly, verbally and/or in writing, with internal and external parties.
Proficiency with Microsoft Office programs.
Must pass the Texas Adjuster license as requested.

Nice To Haves

Knowledge of medical terminology.
Experience in customer service, call-center work, administrative support, healthcare office work, legal support, or similar fast-paced environments.
Bilingual Spanish proficiency, valued for communicating with injured employees, employers, or partners but not required.
Experience managing multiple tasks while maintaining accuracy and attention to detail.
Familiarity with medical terminology.

Responsibilities

Set up designated claim files and complete requested setup instructions.
Learn multiline or workers’ compensation coverages, verify the correct coverage type, and assign files to adjusters when a supervisor is out, if applicable.
Set up independent medical examinations as needed under direct supervision.
Request and monitor medical treatment for designated claims in accordance with corporate claim standards.
Review and approve related medical, legal, damage-estimate, and miscellaneous invoices on designated claims.
Assist adjusters with recorded statements.
Negotiate disputed bills or invoices for resolution under direct supervision.
Make referrals to outside vendors, such as legal, surveillance, or case-management providers, on designated cases under direct supervision, as appropriate.
Coordinate timely and effective communication with clients, claimants, and other appropriate parties throughout the claim adjustment process.
Authorize and make claim payments using a claim payment program, in accordance with industry standards and established authority levels, under direct supervision.
Summarize correspondence and medical records in claim log notes and file them in the appropriate claim.
Compute disability rates in accordance with state laws under direct supervision, when appropriate.
Assist with running and updating reports as needed.
Return provider calls.
Review and maintain a personal diary in the claim system.
Provide technical and clerical claims support to designated clients and claim staff as requested.
Work document and bill queues.
Process voids, refunds, and recoveries.
Act as backup for an adjuster who is out of the office.
Support client satisfaction and comply with corporate claim standards and special client handling instructions.
Handle claim overflow as needed.

Benefits

Four weeks of PTO, accruing throughout the year in accordance with company policy.
10 paid holidays in the first year.
Medical insurance.
Dental insurance.
Vision insurance.
Life insurance.
Disability insurance.
401(k).
Employee Stock Ownership Plan (ESOP).
Structured training and advancement opportunities.
Supportive, team-based environment with mentoring and development.
The role may qualify for bonuses or additional forms of pay.