Workers' Compensation Claim Adjuster

Overview

Workers’ Compensation Claim Advocate (Adjuster)

Location: Lisle, IL (Hybrid – In office 2x/month after training) Schedule: Monday–Friday, 8:00 AM to 4:30 PM CST Salary Range: $55,000 – $65,000 Client Support: Dedicated Client Account (Illinois Public Risk Fund)

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.

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.

The Workers’ Compensation Claim Advocate  position 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.

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. 

Qualifications

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.
• 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.

Education and/or Experience

3+ years workers’ compensation claim experience is required (if you do not meet this requirement but feel you have the proper background, please apply)

Computer Skills

Proficient with Microsoft Office programs.

Certificates, Licenses, Registrations

IL or TX Adjuster’s license is preferred.

AIC, ARM or CPCU Designation preferred.

CORE VALUES & PRINCIPLES

Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.

Compensation & Compliance

The posted salary reflects CCMSI’s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. 

CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits.

Visa Sponsorship:

CCMSI does not provide visa sponsorship for this position.

ADA Accommodations:

CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team.

Equal Opportunity Employer:

CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment.

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