Claims Specialist

gaig; Gainesville (FL); Hybrid; USD 70,000 - 92,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off and holidays

401(k) with company match

Commuter benefits

Tuition reimbursement

Job summary

SCI Summit Consulting, LLC is seeking an experienced Claims Professional to manage a large portfolio of complex workers’ compensation claims. You will evaluate compensability and liability, conduct investigations, and negotiate settlements within your authority to protect our clients and the company.

The role supports a hybrid work arrangement out of Gainesville, GA or remote from one of the Southeast region states.

Qualifications

• Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or related field.
• Minimum 9 years of experience in property and casualty claims handling.
• Progress toward professional designation (e.g., AIC) preferred.

Responsibilities

• Manage a large inventory of complex claims and evaluate compensability/liability.
• Plan and conduct complex investigations to determine coverage, liability, and damages.
• Negotiate settlements and reserves within authority; attend arbitrations or trials if needed.
• Convey information about coverage and settlements to insureds, claimants, and partners.
• Authorize payments within authority and maintain detailed claim files.
• Lead or participate in decisions regarding talent development for direct reports.
• Perform other duties as assigned.
• Hybrid work from Gainesville, GA office or remote from eligible Southeast states.

Skills

Analytical skills

Negotiation

Problem-solving

Communication skills

Education

Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or related field

Job description

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 a large inventory of complex claims to evaluate compensability/liability.
• Plans and conducts complex claims investigations to confirm coverage and to determine liability, compensability and damages.
• Analyzes and negotiates appropriate claim settlements/reserves within prescribed authority. May attend arbitrations, mediations, depositions, or trials.
• Conveys 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.
• May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports.
• Performs other duties as assigned.
• The person hired for this position will work a hybrid scheduled out of the Gainesville, GA office or remotely from one of the states in our Southeast region including GA, IL, TN,, IN, SC, KY, NC.

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 9 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 broad limits and authority on assignments of the highest technical complexity, requiring specialized knowledge. Demonstrates excellent analytical, negotiation, and problem-solving skills. Maintains strong knowledge of insurance policies, coverage, and claims handling procedures. Maintains knowledge of industry laws and regulations. Advanced 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. Viewed as a senior resource within the Claims department and/or organization.

SCI Summit Consulting, LLC

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.