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The Medical Only Claim Representative role at CCMSI focuses on handling designated medical-only claims and supporting claim staff. This position is integral to maintaining quality claim services and ensuring compliance with corporate standards, ultimately contributing to client satisfaction.
CCMSI
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The Medical Only Claim Representative is responsible for claims handling of designated medical only claims and provide support to claim staff. 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 services as perceived by CCMSI clients and within the corporate claim standards.
Responsibilities: When we hire claim reps at CCMSI, we look for detail oriented professionals who understand that every task supports a real person’s claim experience, value accuracy and responsiveness, and contribute to the team’s success through organization, collaboration, and a strong commitment to service.• Set up and manage medical‑only claim files in accordance with corporate claim standards and applicable laws • Establish reserves and provide reserve recommendations within authorized levels under direct supervision • Review and approve medical and miscellaneous invoices on designated claims; negotiate disputed bills or invoices under supervision • Request and monitor medical treatment in accordance with corporate claim handling standards • Summarize correspondence and medical records in claim system notes and file documentation appropriately • Close claim files when appropriate and retrieve closed files for re‑filing as requested • Provide ongoing support to claim staff on client service teams • Communicate with medical providers, injured workers, and internal partners; frequent phone work is required • Ensure compliance with corporate claim handling standards and special client handling instructions Qualifications: Required:Bodily Injury (IHBI) Adjuster
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