Claims Specialist

Summit; South Carolina; Hybrid; USD 70,000 - 92,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Wellness plans

Paid time off and holidays

401(k) with company match

Commuter benefits

Job summary

SCI Summit Consulting, LLC in Georgia seeks a seasoned claims professional to manage workers’ compensation claims, conduct investigations, and negotiate settlements within authority. The role emphasizes accurate file maintenance and effective communication with insureds, claimants, and partners.

The position is on-site four days a week with one remote day, based in Gainesville, GA, with the option to work remotely in several states.

Qualifications

• Education: Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or related field or equivalent experience.
• Experience: Generally, a minimum of 5 years of experience in property and casualty claims handling.
• Scope and skills: Strong analytical, negotiation, and problem-solving abilities; knowledge of insurance policies, coverage, and claims handling procedures.

Responsibilities

• Manages an inventory of claims to evaluate compensability/liability.
• Plans and conducts claim investigations to confirm coverage and determine liability, compensability and damages.
• Negotiates settlements/reserves within assigned authority; may attend arbitrations, mediations, depositions, or trials.
• Communicates complex information regarding coverage and settlements to insureds, claimants, and external partners.
• Authorizes payments within authority limits and ensures timely processing.
• Maintains detailed claim files and related correspondence.

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.