Workers' Compensation Claim Adjuster

Ccmsi • Lisle, IL

16h • $60,000 - $80,000 • Hybrid

About The Position

CCMSI is seeking the best and brightest talent to join the Illinois Public Risk Fund who is the largest Public Entity Workers’ Compensation pool in the State of Illinois. Illinois Public Risk Fund has a dedicated CCMSI claims team with a staff of 24 and their own dedicated office space. Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don’t just process claims—we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work® , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. The Workers’ Compensation Claim Advocate position is responsible for the investigation and adjustment of assigned workers’ compensation 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 workers’ compensation claim services as perceived by CCMSI clients and within our corporate claim standards.

Requirements

• Excellent oral and written communication skills.
• Initiative to set and achieve performance goals.
• Good analytic and negotiation skills.
• 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.
• 5+ years workers’ compensation 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.
• IL or TX Adjuster’s license is preferred.
• AIC, ARM or CPCU Designation preferred.

Responsibilities

• Investigate, evaluate and adjust workers’ compensation 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 workers’ compensation claims.
• Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of workers’ compensation 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 workers’ compensation 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 workers’ compensation 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.

Benefits

• 4 weeks ( Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
• Comprehensive benefits : Medical, Dental, Vision, Life, and Disability Insurance
• Retirement plans : 401(k) and Employee Stock Ownership Plan (ESOP)
• Career growth : Internal training and advancement opportunities
• Culture : A supportive, team-based work environment

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed