Claims Specialist

Summit; Gainesville (GA); Hybrid; USD 70,000 - 92,000; Full time

Benefits offered by this job

Medical, dental, and vision

401(k) with company match

Commuter benefits

Paid time off

Tuition reimbursement

Job summary

SCI Summit Consulting, LLC in Gainesville, GA seeks an experienced claims professional to manage an inventory of workers’ compensation claims, investigate coverage, determine liability, and negotiate settlements. You will handle authorizations, maintain detailed files, and collaborate with insureds and external partners.

Core in-office days are Tue–Thu with one remote day; candidates may work remotely in GA, IL, IN, KY, NC, SC, TN, or operate from Gainesville.

Qualifications

• Bachelor’s degree in Business Administration, Risk Management and Insurance, Finance, or related field.
• Generally, a minimum of 5 years of experience in property and casualty claims handling.
• Ability to organize and prioritize caseloads to ensure timely resolution of claims.
• Non-exempt status in CA and WA for this role.

Responsibilities

• Manages an inventory of claims to evaluate compensability/liability.
• Plans and conducts claim investigations to confirm coverage and determine liability, compensability, and damages.
• Determines and negotiates settlements/reserves within authority; may attend arbitrations or trials.
• Conveys complex information regarding coverage and settlements to insureds and claimants.
• Authorizes payments per authority limits and ensures timely disbursement.
• Maintains accurate claim files with correspondence, reports, and settlements.
• Great American culture emphasizes connection and relationships; hybrid work: 4 days in office, 1 day remote.
• Role based in Gainesville, GA with on-site or remote options across listed states.

Skills

Claims handling

Negotiation

Analytics

Communication

Education

Bachelor's degree in Business Administration, Risk Management and Insurance, Finance, or related field

Job description

Company

SCI Summit Consulting, LLC

Summit provides independent insurance agents and their clients with market-leading workers’ comp insurance and elite customer service. We’re growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South, Midwest, and Mid-Atlantic.

Our strength comes from a single-minded focus on workers’ comp and a commitment to long-term customer relationships. Summit is who you turn to when you need a specialist who not only knows workers’ comp but also gets to know your business and your priorities.

Our field team members are located in every state in which we operate.

Summit is a member of the Great American Insurance Group where our highest goal is for all employees to feel included, respected, and empowered to perform at their best.

Essential Job Functions And Responsibilities

• Manages an inventory of claims to evaluate compensability/liability.
• Plans and conducts claim investigations to confirm coverage and to determine liability, compensability and damages.
• Determines and negotiates appropriate claim settlements/reserves within prescribed authority. May attend arbitrations, mediations, depositions, or trials.
• Conveys moderately complex information regarding coverage and settlements to insureds, claimants, and external partners.
• Authorizes payments in accordance with assigned authority limit and ensures payments are made in a timely manner.
• Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements.
• Performs other duties as assigned.
• Great American’s culture is built on connection, shared learning, and strong relationships. To support this, employees in this role are expected to be on-site four days a week, with the flexibility to work one day remotely. Core in-office days are Tuesday–Thursday, with the fourth day determined by business needs.
• The person hired for this position will work out of the Gainesville, GA office which offers a hybrid work environment (4 days in office, 1 day remote) or will work remotely in the following states: Georgia, Illinois, Indiana, Kentucky, North Carolina, South Carolina, Tennessee.

Job Requirements

Education: Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field or equivalent experience.

Experience: Generally, a minimum of 5 years of experience in property and casualty claims handling. Completion of or continuing progress toward a professional designation preferred, such as Associate in Claims (AIC).

Scope of Job/Qualifications: Works within significant limits and authority on assignments of higher technical complexity and coordination. Demonstrates strong analytical, negotiation, and problem-solving skills. Demonstrates knowledge of insurance policies, coverage, and claims handling procedures. Maintains knowledge of industry laws and regulations. Demonstrates ability to organize and prioritize caseloads, ensuring timely resolution of claims. Excellent interpersonal and communication skills with the ability to build relationships and lead negotiations. Proven ability to handle confidential information with discretion.

This job is non-exempt in California and Washington.

Salary Range

$69,600.00 -$92,400.00

Benefits

We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.

Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers.

• Excludes seasonal employees and interns.