CCMSI

Workers' Compensation Claim Representative II

US-LA-Metairie
Job ID
2018-2261
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 claims.  This position may be used as an advanced training position for consideration for promotion to a more senior level claim position.  Additionall, this position is accountable for the quality of claim services as perceived by CCMSI clients and within our corporate claim standards.

 

Responsibilities

  • Investigate and adjust 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 claim.  Negotiate any disputed bills for resolution.
  • Authorize and make payment of 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.

Qualifications

Education and/or Experience   

Bachelor degree preferred, Associate degree required.

One to five years claim processing experience.

Knowledge of medical terminology required. 

 

                                                              

Computer Skills   

Proficient using Microsoft Office.  Basic computer skills required                              

 

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.

 

Other Physical Demands

  • Work requires the ability to stoop, bend, reach and grab with arms and hands, manual dexterity,

      

 

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 included Medical, Dental, Vision, Prescription Drug, Flexible Spending, Life, ESOP and 401K.

 

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