Senior Workers' Comp Claims Consultant — Hybrid

Socket.dev; Reading (MA); On-site; USD 85,000 - 95,000; Full time

Benefits offered by this job

PTO 4 weeks

Benefits package

401(k) + ESOP

Career growth

Team culture

Job summary

CCMSI in Reading, MA is seeking an experienced Workers’ Compensation Claim Consultant to manage a complex portfolio with empathy and sound judgment. This full life-cycle WC adjuster position requires 5+ years of hands-on claims experience and offers a path to advanced roles.

Hybrid after training; salary range $85,000-$95,000; adjuster’s license required for CT and RI; bilingual Spanish a plus. Comprehensive benefits and career growth opportunities are provided by CCMSI.

Qualifications

• Five or more years of Workers’ Compensation claims experience.
• Proficiency with Microsoft Office products, including Word, Excel, and Outlook.

Responsibilities

• Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
• Establish reserves and/or provide reserve recommendations within established reserve authority levels.
• Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims.
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
• Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
• Assist in the selection, referral and supervision of designated claim files sent to outside vendors.
• Assess and monitor subrogation claims for resolution.
• Review and maintain personal diary on claim system.
• Client satisfaction.
• Prepare reports detailing claim status, payments and reserves, as requested.
• Compute disability rates in accordance with state laws.
• Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
• Prepare newsletter articles, as requested.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Handle more complex and involved claims than lower level claim positions with minimum supervision.
• Conduct claim reviews and/or training sessions for designated clients, as requested.
• Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

Skills

WC claims experience

Microsoft Office

Education

Bachelor's degree (preferred)

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

CCMSI in Reading, MA is seeking an experienced Workers’ Compensation Claim Consultant to manage a complex portfolio with empathy and sound judgment. This full life-cycle WC adjuster position requires 5+ years of hands-on claims experience and offers a path to advanced roles.

Hybrid after training; salary range $85,000-$95,000; adjuster’s license required for CT and RI; bilingual Spanish a plus. Comprehensive benefits and career growth opportunities are provided by CCMSI.