Multi-Line Claim Specialist

Ccmsi•Maitland, FL

11h•Hybrid

About The Position

The Multi-Line Claim Specialist position is responsible for the investigation and adjustment liability claims for a dedicated client account and is responsible for investigating and adjusting a variety of claims, including commercial auto PD/BI (desk will consist of product and commercial auto claims). This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The position is also accountable for the quality of multi-line claim services as perceived by CCMSI clients and within our corporate claim standards. This is a full life-cycle ML adjuster position within a TPA environment, and only candidates with proven Multi Line claims experience will be considered.

Requirements

Excellent oral and written communication skills.
Initiative to set and achieve performance goals.
Good analytic and negotiation skills.
Ability to cope with job pressures in a constantly changing environment.
Knowledge of all lower level claim position responsibilities.
Must be detail oriented and a self-starter with strong organizational abilities.
Ability to coordinate and prioritize required.
Flexibility, accuracy, initiative and the ability to work with minimum supervision.
Discretion and confidentiality required.
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.
10+ years multi-line claim experience is required.
Proficient with Microsoft Office programs.

Nice To Haves

Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required
AIC, ARM or CPCU Designation preferred.

Responsibilities

Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws.
Establish reserves and/or provide reserve recommendations within established reserve authority levels.
Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims.
Negotiate any disputed bills or invoices for resolution.
Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
Review and maintain personal diary on claim system.
Assess and monitor subrogation claims for resolution.
Compute disability rates in accordance with state laws.
Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process.
Provide notices of qualifying claims to excess/reinsurance carriers.
Compliance with Corporate Claim Handling Standards and special client handling instructions as established.