Claims Representative/Medical Only Adjuster (Hybrid)

Summit Consulting•Lakeland, FL

1d•Hybrid

About The Position

Summit provides independent insurance agents and their clients with market-leading workers’ comp insurance and elite customer service. We’re growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South, Midwest, and Mid-Atlantic. Our strength comes from a single-minded focus on workers’ comp and a commitment to long-term customer relationships. Summit is who you turn to when you need a specialist who not only knows workers’ comp but also gets to know your business and your priorities. Our field team members are located in every state in which we operate. Summit is a member of the Great American Insurance Group where our highest goal is for all employees to feel included, respected, and empowered to perform at their best.

Requirements

6 months to 3 years of related experience.
Experience in handling Medical Only claims for the following states is preferred: Florida, Pennsylvania, Delaware, Maryland, District of Columbia, or Virginia.

Nice To Haves

Experience in handling Medical Only claims for the following states is preferred: Florida, Pennsylvania, Delaware, Maryland, District of Columbia, or Virginia.

Responsibilities

Investigates and maintains claims.
Reviews and evaluates coverage and/or liability.
Secures and analyzes necessary information (i.e., reports, policies, appraisals, releases, statements, records or other documents) in the investigation of claims.
Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions or trials as necessary.
Conveys simple to moderately complex information (coverage, decision, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations.
Ensures that claims payments are issued in a timely and accurate manner.
Ensures that claims handling is conducted in compliance with applicable statutes, regulations and other legal requirements, and that all applicable company procedures and policies are followed.
Performs other duties as assigned.