Senior Workers Compensation Claim Specialist Nevada
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. The Workers' Compensation Claim Specialist is responsible for the full investigation, evaluation, and adjustment of assigned Workers' Compensation indemnity claims for a dedicated client account. The role requires independent claim handling, strong jurisdictional knowledge, and adherence to CCMSI corporate standards and client-specific handling instructions. This position is a true Workers' Compensation adjusting role. It is not an HR, consulting, or administrative position. The role requires full responsibility for the investigation, evaluation, negotiation, and resolution of Workers' Compensation claims in accordance with state laws and client handling instructions.
Requirements
- Active Nevada Workers' Compensation Adjuster License - REQUIRED
- Arizona license accepted via NV ↔ AZ reciprocity , if applicable
- Claims handled are Nevada-based , with minimal Arizona exposure as needed
- Proven experience adjusting Workers' Compensation indemnity claims
- Strong working knowledge of Nevada Workers' Compensation statutes and regulations
- Ability to independently manage a full caseload for a dedicated account
- Excellent written and verbal communication skills
- Strong analytical, organizational, and negotiation abilities
- High level of professionalism, discretion, and confidentiality
- Reliable, predictable attendance during scheduled client service hours
- Proficiency with Microsoft Office and claim management systems
Nice To Haves
- Experience supporting a single-client or dedicated account model
- Prior experience with Nevada-only WC claim handling
- Professional designations such as AIC, ARM, or CPCU
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
Responsibilities
- Investigate, evaluate, and adjust assigned Workers' Compensation claims in compliance with Nevada Workers' Compensation laws
- Manage a full indemnity caseload for a single dedicated account
- Establish reserves and provide reserve recommendations within assigned authority
- Review, approve, and negotiate medical, legal, and related claim expenses
- Authorize and issue claim payments in accordance with established procedures and authority limits
- Negotiate settlements in alignment with corporate standards, client instructions, and state regulations
- Coordinate and oversee outside vendors including defense counsel, case management, and medical providers
- Maintain accurate documentation, activity notes, and diaries within the claim system
- Identify and monitor subrogation opportunities through resolution
- Calculate and apply disability rates and benefits in accordance with state law
- Communicate effectively with injured workers, employers, attorneys, and internal partners
- Ensure compliance with CCMSI claim handling standards and client-specific requirements
Benefits
- 4 weeks PTO (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
Senior
Education Level
No Education Listed
Number of Employees
1,001-5,000 employees
