Experienced WC Claim Adjuster – California ADR Program (CA | Remote | SIP Required)

CCMSI • Irvine, CA

99d • $80,000 - $85,000

About The Position

The Workers’ Compensation Claim Consultant is responsible for handling California workers’ compensation claims for a single dedicated Alternate Dispute Resolution (ADR) client account. This role requires California jurisdiction experience and an active CA Adjuster’s License, along with the Self-Insurance Administrator Certificate (SIP). You’ll join a team of 10 adjusters and play a key role in ensuring quality claim handling through compliance with client guidelines, state laws, and CCMSI claim standards. Performance is measured by accuracy, timeliness, and client satisfaction, with a focus on no penalties, current diary management, complete documentation, and timely payments.

Requirements

• Three or more years of experience adjusting California workers’ compensation claims
• California Adjuster’s License
• Self-Insurance Administrator Certificate (SIP)
• Strong written and verbal communication skills
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook)

Nice To Haves

• Experience with Alternate Dispute Resolution (ADR) claims
• Strong organization, multitasking, and customer service skills

Responsibilities

• Investigate, evaluate, and adjust assigned California workers’ compensation claims in compliance with jurisdictional requirements and ADR processes.
• Establish and monitor reserves, authorize claim payments, and negotiate settlements within authority and client guidelines.
• Review medical, legal, and vendor invoices to confirm accuracy and appropriateness.
• Maintain thorough documentation and diary updates in the claim system.
• Communicate effectively with clients, claimants, and involved parties throughout the claim process.
• Participate in claim reviews, hearings, and mediations as needed.
• Ensure compliance with state laws, CCMSI claim handling standards, and client-specific requirements.

Benefits

• Employee Stock Ownership Plan (ESOP): We’re employee-owned, so your success is our success.
• Comprehensive Benefits Package: Includes medical, dental, vision, life insurance, disability, and 401(k).
• Generous Time Off: 4 weeks of paid time off in your first year, plus 10 paid holidays.
• Career Growth: Structured training, career progression pathways, and opportunities to advance within CCMSI.
• Supportive Environment: Manageable caseloads and a collaborative, team-focused culture.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level