Medical Only Claims Representative

Great American Insurance Group

Illinois

Remote

USD 56,000 - 76,000

Full time

11 days ago

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Benefits offered by this job

Medical insurance
Dental insurance
Vision coverage
Wellness program
Parental leave
Adoption assistance
Tuition reimbursement
Paid time off
Paid holidays
401(k) match
Employee stock purchase plan
Commuter benefits

Job summary

SCI Summit Consulting, LLC in Illinois seeks a claims role focused on workers' compensation with remote work options within the state. You will handle claim inventories, investigate coverage, and determine liability and settlements while maintaining detailed files and timely payments.

The ideal candidate holds a Bachelor's degree in a related field and has 6 months of P&C claims experience; professional designation is a plus.

Qualifications

  • Bachelor’s degree in Business Administration, Risk Management and Insurance, Finance, or related field.
  • Minimum 6 months of experience in property and casualty claims handling.
  • Professional designation (e.g., AIC) preferred.

Responsibilities

  • Manages an inventory of claims to evaluate compensability and liability.
  • Conducts claim investigations to confirm coverage and determine liability and damages.
  • Negotiates settlements or reserves within authority; may attend arbitrations or trials.
  • Communicates coverage and settlement information to insureds, claimants, and partners.
  • May authorize payments within authority and ensure timely payments.
  • Maintains accurate claim files with correspondence, reports, and settlements.
  • Performs other duties as assigned.

Skills

Negotiation
Analytical thinking
Problem-solving
Communication skills

Education

Bachelor’s degree in Business Administration, Risk Management and Insurance, or Finance

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 an inventory of claims to evaluate compensability/liability.
  • Conducts claim investigations to confirm coverage and to determine liability, compensability and damages.
  • Determines and may negotiate appropriate claim settlements/reserves within prescribed authority. May attend arbitrations, mediations, depositions, or trials.
  • Conveys routine to moderately complex information regarding coverage and settlements to insureds, claimants, and external partners.
  • May authorize 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.
  • This role is remote in Illinois.
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 6 months 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 specific limits and authority on assignments of moderate technical complexity and coordination. Demonstrates functional analytical, negotiation, and problem-solving skills. Demonstrates knowledge of insurance policies, coverage, and claims handling procedures. Develops and maintains knowledge of industry laws and regulations. Demonstrates ability to organize and prioritize caseloads, ensuring timely resolution of claims. Strong interpersonal and communication skills with the ability to build relationships and handle negotiations. Proven ability to handle confidential information with discretion.

Company:

SCI Summit Consulting, LLC

Salary Range:

$56,400.00 -$75,600.00

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 .

*Excludes seasonal employees and interns.

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