Education and/or Experience:
10+ years multi-line claim experience is required. Bachelors Degree is preferred. Computer Skills, Proficient with Microsoft Office programs.
Certificates, Licenses, Registrations: Adjusters license may be required based upon jurisdiction.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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.
At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile.
Reasons you should consider a career with CCMSI:
Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm.
Career development: CCMSI offers robust internships and internal training programs for advancement within our organization.
Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP.
Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads.
Construction Defect Claim Specialist
This position is responsible for the investigation and adjustment of assigned General Liability Property Damage, Bodily Injury and Construction Defect claims. The Construction Defect Claim Specialist is accountable for the quality of claim services as perceived by CCMSI clients and within our corporate claim standards.
Investigate and evaluate Construction Defect claims in accordance with established claim handling standards and laws.
Determine and analyze coverage and prepare various coverage letters.
Manage litigated files working with defense counsel.
Establish reserves and/or provide reserve recommendations within established reserve authority levels.
Maintain required state licensing and continuing education.
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 General Liability 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 General Liability files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
Review and maintain personal diary on claim system.
Prepare reports detailing claim status, payments and reserves, as requested.
Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
Provide notices of qualifying claims to excess/reinsurance carriers.
Handle more complex and involved General Liability 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.
Performs other duties as assigned.