Multi-Line Claim Consultant

Ccmsi•Chicago, IL

1d•Hybrid

About The Position

The Multi-Line Claim Consultant investigates, evaluates, and adjusts assigned multi-line claims in a third-party administrator environment. This is a full life-cycle adjuster role handling more complex claims than lower-level claim positions, with minimal supervision. The position may also serve as advanced training for potential promotion to a more senior claim role. The consultant is accountable for the quality of claim services as experienced by CCMSI clients and for compliance with corporate claim standards, client-specific instructions, and applicable laws. The role is hybrid, reporting to the Chicago, Illinois region; Chicago-area candidates are preferred. It may be performed remotely in states where CCMSI is authorized to hire. The stated schedule is 8:00 a.m.–4:30 p.m. The salary range is $65,000–$75,000, with actual compensation dependent on qualifications, experience, location, and internal equity. The role may qualify for bonuses or other forms of pay. CCMSI does not provide visa sponsorship. CCMSI describes itself as the largest privately owned third-party administrator and a certified Great Place to Work®. Its employee-owners work collaboratively to deliver customized claim solutions for clients. The company emphasizes transparency, integrity, excellence, ownership, teamwork, and support for the people represented by each claim.

Requirements

At least 5 years of multi-line claim experience.
Excellent oral and written communication skills.
Initiative to set and achieve performance goals.
Good analytical and negotiation skills.
Ability to cope with job pressures in a constantly changing environment.
Knowledge of responsibilities associated with lower-level claim positions.
Detail-oriented, self-starting approach and strong organizational abilities.
Ability to coordinate and prioritize work.
Flexibility, accuracy, initiative, and ability to work with minimal supervision.
Discretion and ability to maintain confidentiality.
Reliable, predictable attendance during client service hours.
Responsive to internal and external client needs.
Proficiency with Microsoft Office programs.
An adjuster’s license may be required depending on jurisdiction.

Nice To Haves

Bachelor’s degree preferred.
Bilingual Spanish proficiency is highly valued but not required.
Experience handling municipal claims.

Responsibilities

Investigate, evaluate, and adjust multi-line claims in accordance with claim-handling standards and applicable laws.
Establish reserves or provide reserve recommendations within assigned authority levels.
Review, approve, or oversee medical, legal, damage-estimate, and miscellaneous invoices to determine whether charges are reasonable and related to claims; negotiate disputed bills or invoices.
Authorize and make claim payments using the claim payment program, following CCMSI procedures, industry standards, and payment authority limits.
Negotiate settlements in accordance with corporate claim standards, client-specific instructions, and state laws, as appropriate.
Assist with selecting, referring, and supervising outside vendors assigned to multi-line claim files, including legal, surveillance, and case-management vendors.
Assess and monitor subrogation claims through resolution.
Review and maintain a personal diary in the claim system.
Prepare reports on claim status, payments, and reserves as requested.
Compute disability rates in accordance with state laws.
Coordinate timely communications with clients, claimants, and other appropriate parties throughout claim adjustment.
Prepare newsletter articles as requested.
Provide notice of qualifying claims to excess or reinsurance carriers.
Handle complex and involved multi-line claims with minimal supervision.
Conduct claim reviews or training sessions for designated clients as requested.
Attend and participate in hearings, mediations, and informal legal conferences, as appropriate.
Comply with corporate claim-handling standards and special client-handling instructions.
Deliver thorough investigations, strong documentation, well-supported decisions, and timely, accurate claim-file progress.
Maintain compliance with jurisdictional and client standards and communicate proactively with clients.

Benefits

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