Senior Workers’ Compensation Adjuster – California Jurisdiction (Remote)
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 seeking an experienced Workers’ Compensation Claim Specialist (Sr. Adjuster) to join our team supporting California jurisdiction claims. This is a remote position that reports to our Las Vegas, NV branch, with a Monday–Friday schedule operating in Pacific Standard Time. As a senior-level adjuster, you will manage a multi‑account desk and handle California workers’ compensation claims from start to finish, including AOE/COE determinations, benefit calculations, proactive communication, and full file resolution. Please note: This is a claims adjuster role responsible for full cradle‑to‑grave claim handling within a TPA environment. It is not an HR, consulting, or employer‑side position.
Requirements
- SIP certification or California Workers’ Compensation Claims Adjuster Certificate.
- 10+ years of California workers’ compensation adjusting experience.
- Strong command of CA workers’ compensation statutes, timelines, and benefit calculations.
- Demonstrated ability to manage a multi‑account desk with competing priorities.
- Excellent written and verbal communication skills.
- Proven analytical, investigative, and negotiation skills.
- Strong organizational ability and a high level of accuracy.
- Initiative, dependability, and the ability to work independently with minimal supervision.
- Commitment to confidentiality, client service, and professional integrity.
- Reliable, predictable attendance during PST business hours.
Nice To Haves
- Bilingual in English and Spanish.
- AIC, ARM, or CPCU designations.
Responsibilities
- Investigate, evaluate, and adjust California workers’ compensation claims in alignment with CCMSI standards and state regulations.
- Make clear and defensible AOE/COE determinations.
- Authorize and issue timely benefit payments, including accurate calculation of Temporary Disability benefits.
- Establish reserves and provide reserve recommendations within authority levels.
- Review, approve, or negotiate medical, legal, and miscellaneous invoices.
- Select, coordinate, and oversee outside vendors (legal, case management, surveillance).
- Negotiate settlements in accordance with state law, client instructions, and handling standards.
- Maintain accurate, complete, and timely diary entries and documentation.
- Compute disability rates in accordance with California statutes.
- Communicate effectively with claimants, clients, providers, and attorneys throughout the claim lifecycle.
- Manage excess reporting requirements when applicable.
- Monitor and pursue subrogation opportunities as appropriate.
Benefits
- 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 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
Mid Level
Education Level
No Education Listed
Number of Employees
1,001-5,000 employees
