Multi-Line Claim Consultant

Ccmsi•Reading, MA

7h•Hybrid

About The Position

The Multi-Line Claim Consultant investigates and adjusts assigned multi-line claims in a third-party administrator environment, managing claims through the full life cycle. The role is accountable for the quality of claim services as perceived by CCMSI clients and for compliance with corporate claim standards, client instructions, and applicable laws. It may also serve as an advanced training position for consideration of promotion to a more senior claim role. The consultant handles more complex claims than lower-level claim positions, with minimum supervision. The position is hybrid, reporting to the Reading, Massachusetts region; Reading-area candidates are preferred. It may be performed remotely in states where CCMSI is authorized to hire. The listed schedule is 8:00 a.m.–4:30 p.m. The salary range is $90,000–$100,000, and the role may also qualify for bonuses or other forms of pay. CCMSI describes itself as a privately owned third-party administrator and certified Great Place to Work. The company emphasizes employee ownership, collaboration, career growth, client service, and treating each claim as involving a real person. A bachelor’s degree is preferred, and at least five years of multi-line claim experience is required. Adjuster licensing may be required depending on jurisdiction. Spanish proficiency is valued but not required.

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 orientation, self-direction, and strong organizational abilities.
Ability to coordinate and prioritize work.
Flexibility, accuracy, initiative, and ability to work with minimum supervision.
Discretion and confidentiality.
Reliable, predictable attendance during client service hours.
Responsiveness to internal and external client needs.
Proficiency with Microsoft Office programs.
Adjuster license may be required depending on jurisdiction.

Nice To Haves

Bachelor’s degree preferred.
Bilingual Spanish proficiency is highly valued for communicating with claimants, employers, or vendors, but is not required.

Responsibilities

Investigate, evaluate, and adjust multi-line claims in accordance with claim-handling standards and applicable laws.
Establish reserves or provide reserve recommendations within established authority levels.
Review, approve, or oversee medical, legal, damage-estimate, and miscellaneous invoices to determine whether they are reasonable and related to assigned claims.
Negotiate disputed bills or invoices toward resolution.
Authorize and make claim payments using the claim payment program, in accordance with CCMSI procedures, industry standards, and established payment authority.
Negotiate settlements in accordance with corporate claim standards, client-specific instructions, and state laws, when appropriate.
Assist in selecting, referring, and supervising outside vendors assigned to claim files, such as 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 and effective communication with clients, claimants, and other appropriate parties throughout the adjustment process.
Prepare newsletter articles as requested.
Provide notices of qualifying claims to excess or reinsurance carriers.
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 instructions.
Deliver thorough investigations, strong documentation, supported decisions, timely file movement, dependable execution, and proactive client communication.

Benefits

Four weeks of paid time off in the first year, 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) 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.