Workers' Compensation Claim Advocate

Overview

Position Title: Workers' Compensation Claim AdvocateLocation: Lisle, IL (Hybrid – In office everyday for first 60-90 days and then in office twice a month or when deeemed necessary by managment for meetings and/or training)Hours: Monday - Friday, 8:00 AM to 4:30 PM  (flexible)Salary Range: $70,000 - $90,000

CCMSI is seeking the best and brightest talent to join the Illinois Public Risk Fund who is the largest Public Entity Workers’ Compensation pool in the State of Illinois.  Illinois Public Risk Fund has a dedicated CCMSI claims team with a staff of 21 and their own dedicated office space.  This team works in office twice a month. 

The posted salary reflects CCMSI’s good-faith estimate of the base pay range for this role, in accordance with applicable pay transparency laws. Actual compensation will depend on qualifications, experience, and internal equity. Additional compensation may include bonuses, benefits, or other forms of pay. A full summary of benefits—including Medical, Dental, Vision, Life Insurance, ESOP, and 401K—is available upon request. Please discuss any compensation and benefits questions with our hiring team.

CCMSI is an Affirmative Action / Equal Employment Opportunity employer. Background checks are conducted in compliance with applicable laws.

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.

The Workers’ Compensation Claim Advocateposition is responsible for the investigation and adjustment of assigned workers’ compensation claims. This position may be used as an advanced training position for promotion consideration for supervisory/management positions.  The position is also accountable for the quality of workers’ compensation claim services as perceived by CCMSI clients and within our corporate claim standards.

This position is a remote position that will required up to 4% of Travel which is one to two client meetings in office per month in our Lisle, IL office. 

Responsibilities

• Investigate, evaluate and adjust workers’ compensation 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 workers’ compensation claims. Negotiate any disputed bills or invoices for resolution. 
• Authorize and make payments of workers’ compensation 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 workers’ compensation claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) 
• Review and maintain personal diary on claim system. 
• Assess and monitor subrogation claims for resolution. 
• Compute disability rates in accordance with state laws. 
• Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the workers’ compensation claim adjustment process. 
• Provide notices of qualifying claims to excess/reinsurance carriers. 
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established. 
• Performs other duties as assigned.

Qualifications

What You Bring

     ✔ Attention to Detail – Accuracy is essential     ✔ Multitasking Skills – Manage multiple tasks efficiently.     ✔ Basic Computer Proficiency – Experience with Microsoft Word, Excel, and Outlook.

Physical Requirements

• Ability to sit or stand for extended periods.
• Light lifting (up to 15 lbs).
• Visual and auditory acuity to perform essential job functions.

Education and/or Experience    

3+ years workers’ compensation claim experience is required.

Computer Skills            

Proficient with Microsoft Office programs.

Certificates, Licenses, Registrations

IL or TX Adjuster’s license is preferred 

AIC, ARM or CPCU Designation preferred.

At CCMSI, we are committed to our Core Values, including integrity, client service, and continuous improvement.

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