Workers’ Compensation Adjuster – Midwest National Accounts

Ccmsi • Chicago, IL

3d • Remote

About The Position

The Workers’ Compensation Claim Consultant is responsible for the investigation and adjustment of assigned workers’ compensation claims across Midwest jurisdictions, including Kansas, Missouri, Illinois, Iowa, Nebraska, and Indiana, with a strong concentration in Illinois. This role manages claims from assignment through resolution (cradle to grave), including files with litigation exposure, while ensuring compliance with CCMSI claim handling standards, client-specific instructions, and applicable state laws. This position is ideal for experienced adjusters with 3+ years of workers’ compensation claim handling experience who are comfortable managing multi-jurisdictional claims and delivering consistent, high-quality outcomes in a national account environment. The Claim Consultant is accountable for the quality of claim services as perceived by CCMSI clients and plays a key role in delivering responsive, accurate, and timely claim handling. This is a full life-cycle WC adjuster role within a TPA environment, requiring strong communication, follow-through, and the ability to manage a dynamic claim volume.

Requirements

• 3+ years of workers’ compensation claim handling experience
• Strong experience handling Illinois workers’ compensation claims
• Experience managing claims across multiple jurisdictions
• Exposure to or experience with litigated workers’ compensation claims
• Strong analytical, organizational, and decision-making skills
• Excellent verbal and written communication skills with a high standard for responsiveness
• Ability to manage a full caseload independently in a fast-paced environment
• Proficiency in Microsoft Office applications
• Reliable, predictable attendance during assigned client service hours

Nice To Haves

• IA and/or NE adjuster licenses are a plus
• Prior TPA experience handling national or multi-state accounts
• Experience with high-volume or complex claim environments
• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.

Responsibilities

• Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
• Establish reserves and/or provide reserve recommendations within established reserve authority levels.
• Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims.
• Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
• Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
• Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
• Assess and monitor subrogation claims for resolution.
• Review and maintain personal diary on claim system.
• Client satisfaction.
• Prepare reports detailing claim status, payments and reserves, as requested.
• Compute disability rates in accordance with state laws.
• Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Handle more complex and involved claims than lower level claim positions with minimum supervision.
• Conduct claim reviews and/or training sessions for designated clients, as requested.
• Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

Benefits

• 4 weeks (Paid time off that accrues throughout the year in accordance with company policy)
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed