Carrier Quality Control Specialist

Location: Telecommute/Remote
Salary Range: $60,000–$100,000 annually
Schedule: Monday–Friday | 8:00 a.m. – 4:30 p.m. CST 

Work Hours: We understand the importance of work-life balance, and while occasional flexibility may be arranged for special circumstances, the core schedule is not subject to change.

At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile.     

Reasons you should consider a career with CCMSI: 

• Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm. 
• Career development: CCMSI offers robust internships and internal training programs for advancement within our organization. 
• Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP. 
• Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads. “

As a Carrier Quality Control Specialist, you’ll be responsible for the coordination and completion of assigned carrier audits.  This includes, but is not limited to the maintenance of the audit forms, audit schedule, auditors, management action plans, and any questions that are presented related to carrier audits. 

1. Perform internal carrier audits in various offices throughout the company. Follow the internal audit guidelines in order to produce a professional, objective audit for each office.  This will ensure compliance with Corporate Claim Best Practices, carrier handling/reporting requirements, and in accordance with applicable laws. 

2. Provide education, training and assist in the development of claim adjusters areas of improvement. 

3. Creating and maintaining Carrier Compliance processes that support compliance with, but not limited to, regulatory, EDI, OFAC, and carrier specific rules. 

4. Attend periodic carrier audit meetings or educational seminars to keep the process current with industry standards. 

5. Stimulate and support teamwork efforts of client service teams and company. 

6. Develop, revise and implement workflow processes to ensure efficiencies and provide oversight of individual workloads, as appropriate. 

7. 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. 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 carrier needs.

Ability to clearly communicate verbally and/or in writing both internally and externally.

Education and/or Experience    

Bachelor’s Degree or 10+ years claim experience.

Three (3) years supervisory experience preferred.

Computer Skills           

Proficient with Microsoft Office programs. 

Certificates, Licenses, Registrations

 AIC designation preferred.

WORKING CONDITIONS

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 (check all that apply)

• Work requires the ability to sit or stand up to 7.5 or more hours at a time.
• Work requires sufficient auditory and visual acuity to interact with others

Compensation & Compliance

The posted salary reflects CCMSI’s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.

CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits.

Visa Sponsorship:
CCMSI does not provide visa sponsorship for this position.

ADA Accommodations:
CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team.

Equal Opportunity Employer:
CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment.

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.

We believe in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who:

• Act with integrity

• Deliver service with passion and accountability

• Embrace collaboration and change

• Seek better ways to serve

• Build up others through respect, trust, and communication

• Lead by example—no matter their title

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