Claim Associate I (P&C)

📍 Location: Danville, IL
🕒 Schedule: Monday – Friday, 8:00 AM to 4:30 PM (37.5 hours/week)
💵 Compensation: $16-$18/hr
📅 Status: Full-Time, In-Office

The posted salary reflects CCMSI’s good-faith estimate of the base pay range for this role, in accordance with applicable pay transparency laws. Actual compensation will depend on qualifications, experience, and internal equity. Additional compensation may include bonuses, benefits, or other forms of pay. A full summary of benefits—including Medical, Dental, Vision, Life Insurance, ESOP, and 401K—is available upon request. Please discuss any compensation and benefits questions with our hiring team.

CCMSI is an Affirmative Action / Equal Employment Opportunity employer. Background checks are conducted in compliance with applicable laws.

Assist Indemnity and/or P&C Adjusters with technical and clerical support of designated claims under close supervision. This position may be used as a training position for consideration of promotion to the claims Level Up program. Is accountable for the quality of claim service as perceived by CCMSI clients and within Corporate Claim Standards.

1. Set up designated claim files and complete all set up instructions, as requested.
2. Learn multi line coverages, check claim for correct coverage type, assign out files to adjusters when supervisor is out, if applicable.
3. Set up independent medical exams as deemed necessary under direct supervision.
4. Request and monitor medical treatment of designated claims in accordance with corporate claim standards.
5. Review and approve related medical, legal, damage estimates and miscellaneous invoices on designated claims. 
6. Assist adjuster with recorded statements.
7. Negotiate any disputed bills/invoices for resolution under direct supervision.
8. As appropriate, make referrals to outside vendors on designated cases under direct supervision. (i.e. legal, surveillance, case management, etc.)
9. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
10. Authorize and make payments on claims utilizing a claim payment program in accordance with industry standards and within established authority levels under direct supervision.
11. Summarize all correspondence and medical records in claim log notes as well as file same in the appropriate claim.
12. Compute disability rates in accordance with state laws under direct supervision, when appropriate.
13. Handle management of Navex and member/client complaints, if applicable.
14. Assist in running and updating reports as needed.
15. Return provider calls.
16. Review and maintain personal diary on claim system.
17. Provide technical and clerical claims support to designated clients and claim staff, as requested.
18. Working document and bill queues.
19. Process voids, refunds and recoveries.
20. Act as backup for adjuster or supervisor when out of the office.
21. Client Satisfaction.
22. Compliance with corporate claim standards and special client handling instructions as established.
23. Handle claim overflow as needed.
24. Performs other duties as assigned.

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.
• Ability to operate general office equipment and perform clerical duties.
• 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     

Associate’s degree or two year’s related business experience.

Knowledge of medical terminology preferred.

Computer Skills            

Proficient with Microsoft Office programs. 

Certificates, Licenses, Registrations

Must pass Texas Adjuster license as requested.

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