Senior Special Claims Investigator (IL)

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.At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.Essential Job Functions And ResponsibilitiesExercises independent judgment within broad authority on complex workers’ compensation claims, including catastrophic injuries and litigated files, requiring technical and jurisdictional expertise.Strategically orchestrates and leads comprehensive claims investigations to confirm coverage and to determine liability, compensability, and damages.Demonstrates advanced analytical, negotiation, and problem-solving skills specific to workers’ compensation claim resolution.Maintains expert-level knowledge of workers’ compensation insurance policies, statutory benefits, and claims handling procedures across multiple jurisdictions.Stays current with evolving workers’ compensation laws, regulations, and case law to ensure compliance and mitigate risk.Effectively manages a high-volume caseload, prioritizing tasks to meet statutory deadlines and internal performance metrics while ensuring timely and fair claim outcomes.Builds strong relationships with injured workers, employers, medical providers, and attorneys to facilitate claim resolution and promote recovery.May be involved in settlement negotiations and mediations with a focus on cost containment and optimal outcomes for all parties.Handles sensitive and confidential information with the utmost discretion and professionalism.Serves as a senior technical resource and mentor within the Claims department, providing guidance and support to adjusters and team members.Willingness to travel up to 50%–70% of the time for field investigations, mediations, and employer site visits.The person hired for this position must reside in the territory of Illinois.Job RequirementsEducation: Bachelor’s Degree or equivalent experience.Experience: Candidates should possess between 6 to 10 years of experience specializing in Workers Compensation insurance. Preference will be given to those who are actively pursuing or have completed a professional designation, such as CPCU , or a board-certified Workers Compensation adjustor having a valid 620 license.Scope of Job/Qualifications: Works within broad limits and authority on assignments of highly complex technical complexity and coordination. Strong knowledge of Claims investigation laws and regulations. Ability to identify and address subtle details that could impact the outcome of an investigation. Demonstrated advanced ability to organize and prioritize caseloads, ensuring timely completion of investigations. Excellent interpersonal and communication skills to collaborate with appropriate parties to ensure thorough and accurate claims settlements. Proven ability to handle confidential information with discretion. Excellent analytical skills with the ability to use data to analyze situations, identify problems, and develop effective solutions.CompanySCI Summit Consulting, LLCSalary Range$80,180.00 -$117,160.00BenefitsCompensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs.We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees.Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.