Remote Workers' Compensation Claim Adjuster

Overview

Workers' Compensation Claim Consultant

Location: Remote (Reporting to Scottsdale, AZ)Work Hours: Monday-Friday, 8:00 AM to 4:30 PMSalary: $85,000 - $95,000 per year

Jurisdication: California

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 rank 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 valued partners—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 provide an environment where employees enjoy coming to work every day, are equipped with the resources needed to perform their job, and manage realistic caseloads.

Responsibilities

What You’ll Do

As a Workers' Compensation Claim Consultant, you’ll take ownership of claims from investigation through resolution. This role focuses on California jurisdiction claims across multiple accounts in the PEO industry and involves no travel. Responsibilities include:

• Investigate, evaluate, and adjust claims according to established standards and state laws.
• Establish reserves and provide recommendations within established authority levels.
• Review, approve, or provide oversight of medical, legal, and other invoices to ensure they are reasonable and related to designated claims.
• Authorize and make payments in compliance with industry standards and payment authority.
• Negotiate settlements and coordinate communication with clients, claimants, and other parties.
• Assess and monitor subrogation claims for resolution.
• Prepare detailed reports on claim status, payments, and reserves.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Handle more complex claims with minimal supervision.
• Conduct claim reviews and/or training sessions for designated clients, as requested.
• Participate in hearings, mediations, and legal conferences when appropriate.

Qualifications

What You Bring to the Table

Must-Have Skills:

• Deep knowledge of California workers' compensation laws and claims processing.
• Strong organizational abilities with the confidence to prioritize multiple tasks.
• Proficiency in Microsoft Office, especially Excel.
• Exceptional written and verbal communication skills.
• A proactive, self-starter mentality with minimal supervision required.
• 5 years of Workers' Compensation Claim experience in California.

Nice-to-Have Skills:

• California Self-Insurance Administrator's Certificate (SIP) preferred but not required for experienced candidates.

Ready to Elevate Your Career?

This is an exciting opportunity to grow your expertise in claims management while contributing to the success of a dynamic, nationwide organization. If you’re ready to take the next step in your career, apply today and join our exceptional team at CCMSI!

CCMSI is an Affirmative Action / Equal Employment Opportunity employer offering an excellent benefits package, including Medical, Dental, Vision, Prescription Drug, Life, ESOP, 401K, Flexible Spending, and more. CCMSI conducts background checks in accordance with applicable federal, state, and local laws.

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.

#RemoteJobs #WorkersCompensation #ClaimConsultant #CaliforniaWorkersComp #InsuranceCareers #EmployeeOwned #PEOIndustry #WorkFromHome #GreatPlaceToWork #AttentionToDetail #Collaboration #IND123 #LI-Remote #EmployeeOwned #GreatPlaceToWorkCertified

Salary : $85,000 - $95,000