CA Workers' Comp Lien & Medical Management Adjuster – Remote (Rep I)
About The Position
At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don’t just process claims—we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work®, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. We are seeking an experienced Workers’ Compensation Claim Representative I to handle California jurisdiction claims with a focus on lien resolution and lifetime medical management. This remote position supports multiple accounts within the staffing and transportation industries and requires an individual who can manage complex medical issues, negotiate lien settlements, and maintain strong compliance with state and client requirements. This role is ideal for someone who enjoys analytical problem-solving, communicating with medical providers and attorneys, and driving claims toward fair and timely resolution. Important – Please Read Before Applying This is a true insurance claims adjusting role, not an HR, benefits, safety, consulting, or administrative position. Candidates must have direct experience investigating, evaluating, reserving, negotiating, and resolving claims as an adjuster or adjuster supervisor within a carrier, TPA, or similar claims environment.
Requirements
- Minimum 2 years of workers’ compensation claim handling experience, with exposure to lien resolution and/or lifetime medical management.
- SIP certification or Experienced Adjuster designation.
- Excellent written and verbal communication skills.
- Strong time management and organizational abilities with attention to detail.
- Proficiency in Microsoft Office programs (Word, Excel, Outlook).
Nice To Haves
- Prior experience managing claims within the staffing or transportation industries.
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
Responsibilities
- Investigate, evaluate, and adjust workers’ compensation claims in accordance with established procedures and California regulations.
- Negotiate and settle liens with lien claimants, medical providers, and applicant attorneys.
- Handle future medical/lifetime medical claims, ensuring timely authorization and payment of treatment, services, and prescriptions.
- Review medical reports, legal correspondence, and billing to determine reasonableness and relatedness to ongoing claims.
- Coordinate with defense counsel and vendors to resolve complex lien disputes.
- Maintain current and accurate diary, documentation, and billing records.
- Ensure compliance with CCMSI standards, client requirements, and jurisdictional timeframes.
- Deliver exceptional customer service to clients, claimants, and internal partners.
Benefits
- 4 weeks PTO + 10 paid holidays in your first year
- Comprehensive benefits : Medical, Dental, Vision, Life, and Disability Insurance
- Retirement plans : 401(k) and Employee Stock Ownership Plan (ESOP)
- Career growth : Internal training and advancement opportunities
- Culture : A supportive, team-based work environment
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
Number of Employees
1,001-5,000 employees
