Bilingual (Spanish) WC Claim Adjuster II – Full‑Cycle CA Claims (Remote)

Ccmsi•Irvine, CA

20h•$65,000 - $80,000•Remote

About The Position

Workers' Compensation Claim Representative II (Bilingual - Spanish) Location: Remote (Must reside in a location that allows regular travel to Irvine, CA a few times per year) Schedule: Monday–Friday, 8:00 a.m. – 4:30 p.m. PST (37.5 hours per week) Salary Range: $65,000 – $80,000 annually (commensurate with experience) Build Your Career With Purpose at CCMSI 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. Job Summary We’re seeking a Workers’ Compensation Claim Representative II to handle California WC claims for a single carrier client. This is a great role for an experienced adjuster who is confident with full claim ownership—from investigation to resolution—and who thrives in a fast‑paced environment. This position requires excellent communication skills, strong technical knowledge of CA Workers’ Compensation, and the ability to work independently while remaining connected to a supportive team of fewer than 20 colleagues. Bilingual English/Spanish proficiency (spoken & written) is required, and used regularly in claimant, employer, and provider communication. Responsibilities When we hire adjusters, we look for professionals who take ownership of their work, navigate complexity with confidence, and deliver exceptional service with integrity. In this role, you’ll be trusted to manage your files independently while contributing to a collaborative, high‑performing team.

Requirements

Active California Adjuster License
5–10 years of workers’ compensation claim adjusting experience
Bilingual (English/Spanish) — spoken and written
Strong organizational skills and ability to prioritize in a fast‑paced environment
Excellent verbal and written communication skills
Proficiency in Microsoft Office (Word, Excel, Outlook)
Ability to work independently with minimal supervision
Ability to travel to the Irvine, CA office a few times per year

Nice To Haves

SIP certification or CA adjuster certification
Experience working with carrier clients
High-volume caseload experience
Bilingual (Spanish) proficiency — spoken and written — is required for this role.

Responsibilities

Investigate, evaluate, and adjust California workers’ compensation claims in alignment with jurisdictional requirements and CCMSI standards
Communicate clearly with injured workers, employers, providers, attorneys, and other stakeholders
Review, approve, and negotiate medical, legal, and miscellaneous invoices
Determine compensability and authorize benefits within settlement authority
Negotiate settlements with claimants and attorneys
Coordinate and supervise defense counsel as needed
Handle subrogation opportunities and ensure proper recovery efforts
Prepare detailed reports on claims, reserves, and financial activity
Monitor files for excess reporting requirements
Maintain timely diary queues, document queues, and respond to audit standards
Support client service commitments with accuracy and urgency

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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