Associate Claim Specialist

Summary

Join The MEMIC Group as an Associate Claim Specialist to investigate, evaluate, negotiate, and resolve claims of varying complexity. On-the-job training provided. Strong communication skills, attention to detail, flexibility, and the ability to work effectively with other team members are required. Comprehensive benefits package includes health insurance, retirement plans, paid time off, and flexible schedules.

Requirements

• No previous experience needed; on-the-job training provided
• Proficient in Microsoft Office (Word and Excel)
• Must have valid driver’s license
• Strong attention to detail and strong verbal and written communication skills a must
• Must have flexibility and be self-directed with ability to manage time and other resources wisely
• Must have the ability to work effectively with other organizational team members
• If jurisdiction requires, obtain required adjuster licenses within 6 months of employment, or earlier, at manager discretion. Additional licenses may be required throughout course of employment

Responsibilities

• Investigates, evaluates, negotiates, and resolves low, medium and high complexity medical only claims and low complexity lost time claims
• Communicates with insureds, injured workers, agents, brokers, witnesses, attorneys, loss prevention, and underwriters to obtain necessary information
• Administration of timely, appropriate medical and indemnity benefits when applicable
• Evaluates claim exposure, investigates, negotiates, and resolves claims with potential for modified duty or periods of total disability
• Maintains quality claim files in accordance with best practices, company policy, procedures and state workers’ compensation statutes
• Implements Managed Care strategies, coordinates rehabilitation or medical management, processes bills, reviews all mail through ImageRight, and monitors progress as appropriate
• Interacts with State and Federal Boards and Commissions, while establishing and maintain proper reserves, as appropriate
• Keeps up to date on State laws and Company procedures relating to various claims and educates injured worker and/or insured on same
• Participates in in-house and outside training programs to keep up to date on relevant issues/topics

Benefits

• Health Insurance options
• Dental Insurance options and Vision Insurance
• Employee Life Insurance/AD&D and Dependent Life Insurance options
• Short-term & Long-term Disability
• Health Savings Account with potential employer match
• Flexible Medical and Dependent Care Account
• Accident Insurance
• Critical Illness Insurance
• Employee Assistance Program
• Legal/Identify Theft Insurance options
• Long Term Care Insurance
• Pet Insurance
• 401 (k) Retirement Plan with match up to 5%, plus profit sharing & discretionary contributions (subject to vesting)
• 4 weeks of Paid Time Off (PTO)
• 7 paid holidays
• Flextime schedules
• Paid Parental Leave
• Student loan paydown and refinancing assistance
• Educational assistance for job related courses, seminars, certifications or degrees
• One paid day every year to volunteer for your non-profit of choice
• On-site fitness center (Maine & Virginia) or fitness reimbursement
• Subsidized parking
• Sit-Stand desks & daily stretch breaks