Senior Medical Only Claims Representative

Summit; Illinois; Remote; USD 56,000 - 76,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401(k) with company match

Paid time off and holidays

Tuition reimbursement

Commuter benefits

Job summary

SCI Summit Consulting, LLC in the United States seeks an Insurance Claims Adjuster to manage and investigate workers’ compensation claims. You will evaluate compensability, determine liability, negotiate settlements, and maintain detailed claim files.

This remote-in-Illinois role requires a bachelor’s degree and basic claims experience. The company emphasizes strong client service, integrity, and timely settlements, with benefits including medical, dental, vision, 401(k) matching, and PTO.

Qualifications

• Bachelor’s degree or equivalent experience required.
• Proven negotiation, analytical thinking, and problem-solving skills.
• Strong communication and interpersonal abilities.

Responsibilities

• Manages an inventory of claims to evaluate compensability/liability.
• Conducts claim investigations to confirm coverage and liability.
• Determines settlements/reserves within authority; may attend arbitrations.
• Conveys information regarding coverage and settlements to insureds and partners.
• May authorize payments within authority and ensure timely payments.
• Maintains detailed claim files with correspondence and settlements.
• Performs other duties as assigned.
• This role is remote in Illinois.

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.
• 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.

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 http://www.gaig.com/careers.

• Excludes seasonal employees and interns.