CCMSI

Workers' Compensation Claim Representative II

US-NJ-Linwood
Job ID
2017-2118
Category
Claims

Overview

Cannon Cochran Management Services, Inc. (CCMSI) is a leading Third Party Administrator in self-insurance services headquartered in Danville, IL.  We are guided by core values including integrity, insisting on excellence and being passionately focused on customer service.  Those values, coupled with our Employee Stock Ownership Plan (ESOP), engage ownership with our employees and offers top of the line customer service for both our internal and external clients. 

 

This is a perfect opportunity to work in a growing, dynamic work environment.  CCMSI’s emphasis is on customer service and you will be expected to set and achieve performance goals in a challenging and growing team environment. 

 

The Workers' Compensation Claim Representative II is responsible for the investigation and adjustment of assigned workers compensation claims. This position may be used as an advanced training position for future consideration for promotion to a more senior level claim position.  Accountable for the quality of claim services as perceived by CCMSI clients and within our corporate claim standards.

Responsibilities

  • Investigate and adjust workers compensation claims in accordance with established claims handling procedures using CCMSI guidelines and direct supervision.
  • Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing workers compensation claims. Negotiate any disputed bills for resolution.
  • Authorize and make payment of workers compensation claims utilizing a claim payment program in accordance with industry standards and within settlement authority.
  • Negotiate settlements with claimants and attorneys in accordance with client's authorization.
  • Assist in selection and supervision of defense attorneys.
  • Assess and monitor subrogation claims for resolution.
  • Prepare reports detailing claims, payments and reserves.
  • Provide reports and monitor files, as required by excess insurers.
  • Compliance with Service Commitments as established by team.
  • Delivery of quality claim service to clients.
  • Performs other duties as assigned.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

  • Excellent oral and written communication skills.
  • Individual must be a self-starter with strong organizational abilities.
  • Ability to coordinate and prioritize required.  
  • Flexibility, initiative, and the ability to work with a minimum of direct supervision a must. 
  • Discretion and confidentiality required. 
  • Ability to work as a team member in a rapidly changing environment.
  • 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.

 

Education and/or Experience    

Level II Claim Rep will possess excellent claims management skills, typically with 5 to 10 years of experience or equivalent education, along with proven claims handling performance levels.

Associates degree is preferred.

 

Computer Skills            

Proficient with Microsoft Office programs.

 

Certificates, Licenses, Registrations

None required.

 

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Object Handling Categories

Work requires the ability to lift/carry objects routinely as follows:

           Light Lifting:          No lifting of objects weighing more than 15 pounds on a regular basis.

 

   

CORE VALUES & PRINCIPLES

Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.

 

 

CCMSI is an Affirmative Action / Equal Employment Opportunity employer offering an excellent benefit package including Medical, Dental, Prescription Drug, Vision, Flexible Spending, Life, ESOP and 401K.  

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If you are unable to locate a position that you are interested in that meets your qualifications, Connect with CCMSI for general consideration.