Multi-Line Claim Consultant

About the role

The Multi-Line Claim Consultant position is responsible for the investigation and adjustment of assigned Multi-Line claims. This position may be used as an advanced training position for consideration of a promotion to a more senior level claim position. The Multi-Line Claim Consultant is accountable for the quality of claim services as perceived by CCMSI clients and within our corporate claim standards. This is a full life-cycle ML adjuster position within a TPA environment, and only candidates with proven Multi Line claims experience will be considered.

Responsibilities

• Investigate, evaluate and adjust multi-line 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.
• Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of multi-line claims in accordance with CCMSI 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 multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
• Assess and monitor subrogation claims for resolution.
• Review and maintain personal diary on claim system.
• 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 multi-line 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.

Qualifications

• Excellent oral and written communication skills.
• Initiative to set and achieve performance goals.
• Good analytic and negotiation skills.
• Ability to cope with job pressures in a constantly changing environment.
• Knowledge of all lower level claim position responsibilities.
• Must be detail oriented and a self-starter with strong organizational abilities.
• Ability to coordinate and prioritize required.
• Flexibility, accuracy, initiative and the ability to work with minimum supervision.
• Discretion and confidentiality required.
• Reliable, predictable attendance within client service hours for the performance of this position.
• Responsive to internal and external client needs.
• Ability to clearly communicate verbally and/or in writing both internally and externally.

Pay

Salary Range: $65,000-75,000

Schedule

8:00 am-4:30 pm