Claims Specialist

Full Time
Gainesville, GA 30501
Posted
Job description

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.

Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.

Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise.

Essential Job Functions and Responsibilities

  • Investigates and maintains claims:
    • Reviews and evaluates coverage and/or liability.
    • Secures and analyzes necessary information (i.e., reports, policies, appraisals, releases, statements, records, or other documents) in the investigation of claims.
  • Works toward the resolution of claims files, and attends arbitrations, mediations, depositions or trials as necessary.
  • May affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority.
  • Conveys complex information (coverage, decisions, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations.
  • Ensures that claims payments are issued in a timely and accurate manner.
  • Ensures that claims handling is conducted in compliance with applicable statutes, regulations and other legal requirements, and that all applicable company procedures and policies are followed.
  • Provides technical advice to lower level positions and other functional areas.
  • May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports.
  • Performs other duties as assigned.

Job Requirements

Education: Bachelor’s Degree or equivalent experience.

Field of Study: Liberal Arts, Business or a related discipline.

Experience: 6 to 10 years of related experience.

Company:

SCI Summit Consulting, LLC

Benefits:

We offer competitive healthcare, retirement and paid time off benefits.

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