[Hiring] Multi-Line Claim Specialist @Ccmsi

Role Description

The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of assigned general liability claims, specifically handling auto and GL claims. 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.

• 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 multi-line claims.
• Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of multi-line 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 multi-line 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 multi-line 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

• 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.

Requirements

• 8+ years multi-line claim experience is required.
• Bachelor’s Degree is preferred.
• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
• Experience handling municipal claims.

Benefits

• 4 weeks paid time off that accrues throughout the year in accordance with company policy + 10 paid holidays in your first year.
• Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance.
• Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP).
• Career growth: Internal training and advancement opportunities.
• Culture: A supportive, team-based work environment.