Medical Claims Representative – Workers’ Compensation (Hybrid Las Vegas)
About The Position
At CCMSI, we don’t just process claims—we support people. As one of the largest employee-owned Third Party Administrators in the country, 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. Join our Las Vegas claims team as a Workers’ Compensation Medical Only Claim Representative , where you’ll handle medical-only workers’ compensation claims for multiple client accounts across various industries. This position offers structured training, mentorship, and the opportunity to develop foundational adjusting skills in a supportive and collaborative environment. You’ll be responsible for the timely and accurate adjudication of medical-only claims in compliance with Nevada statutes, client expectations, and CCMSI’s handling standards. This position may serve as a training role for future advancement to intermediate-level claim positions.
Requirements
- Associate degree or two (2) years of related business experience
- NV Adjuster’s License or ability to obtain within 60 days of hire (must pass state licensing exam and background check)
- Proficiency in Microsoft Office (Word, Excel, Outlook)
Nice To Haves
- Previous workers’ compensation or claim handling experience
- Knowledge of medical terminology
Responsibilities
- Adjudicate medical-only workers’ compensation claims timely and accurately in accordance with statutory, client, and CCMSI guidelines.
- Establish and maintain claim reserves within authority levels under direct supervision.
- Review, approve, and negotiate medical and miscellaneous invoices to ensure appropriate and related charges.
- Coordinate and monitor medical treatment in compliance with corporate claim standards.
- Document all claim activity, medical updates, and correspondence in the claim system.
- Close claim files when appropriate and assist with file maintenance as needed.
- Provide support to the broader claim team, including client service initiatives and administrative tasks.
- Maintain compliance with all Corporate Claim Standards and client-specific handling instructions.
Benefits
- 4 weeks PTO + 10 paid holidays in your first year
- Medical, Dental, Vision, Life, and Disability Insurance
- 401(k) and Employee Stock Ownership Plan (ESOP)
- Internal training and advancement opportunities
- A supportive, team-based work environment
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
Number of Employees
1,001-5,000 employees
