Claim Assistant

Overview

Launch Your Career as a Claim Assistant at CCMSI – Maitland, FL!

 

Location: In-Office Position (Maitland, FL)Work Hours: Monday-Friday, 8:00 AM to 4:30 PM (1-hour unpaid lunch)Salary: $18.00 - $19.00 per hour (Hourly – 37.5 hours/week)

 

Salary Disclaimer: The posted salary range reflects the anticipated base pay for this role. Actual pay will depend on factors such as qualifications, experience, location, and internal equity. Additional compensation may include bonuses, benefits, or other forms of pay. This range complies with state and local transparency laws. Please discuss any questions about compensation or benefits with our hiring team.

 

This position provides clerical assistance to workers' compensation claim adjusters. As a Claim Assistant, you'll be crucial in supporting claims management, ensuring accuracy, and maintaining high levels of customer service. There’s room for growth as you gain experience in the workers' compensation field!

 

 

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 Claim Assistant will investigate and evaluate contested medical-only claims and handle indemnity cases under close supervision. This position may be used as a training position for consideration of promotion to an intermediate level claim position. Is accountable for the quality of claim service as perceived by CCMSI clients and within Corporate Claim Standards.

Responsibilities

• Investigate, evaluate and adjust contested medical-only claims and handle indemnity claims under direct supervision.  
• Establish reserves and/or provide reserve recommendations within established authority levels under direct supervision. 
• Set up designated claim files and complete all set up instructions, as requested. 
• Set up independent medical exams as deemed necessary under direct supervision. 
• Request and monitor medical treatment of designated claims in accordance with corporate claim standards. 
• Review and approve related medical, legal, damage estimates and miscellaneous invoices on designated claims. Negotiate any disputed bills/invoices for resolution under direct supervision. 
• Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws under direct supervision, when appropriate. 
• As appropriate, make referrals to outside vendors on designated cases under direct supervision. (i.e. legal, surveillance, case management, etc.) 
• Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process. 
• Authorize and make payments on claims utilizing a claim payment program in accordance with industry standards and within established authority levels under direct supervision. 
• Compute disability rates in accordance with state laws under direct supervision, when appropriate. 
• Summarize all correspondence and medical records in claim log notes as well as file same in the appropriate claim. 
• Return provider calls. 
• Review and maintain personal diary on claim system. 
• Provide technical and clerical claims support to designated clients, as requested.  
• Compliance with corporate claim standards and special client handling instructions as established.