Workers' Compensation Claim Adjuster I (St. Louis Hybrid)
About The Position
CCMSI is seeking a Workers' Compensation Claims Representative I to handle workers' compensation claims across multiple accounts, primarily in Missouri and potentially Illinois. The role is suited to an adjuster with workers' compensation or related insurance experience who can manage a full caseload of moderate-complexity claims while continuing to develop technical claim-handling skills and providing quality service to clients and injured workers. The position is based in St. Louis, Missouri. Employees work onsite for their first 30 days for training and onboarding. After successfully completing training, the schedule may transition to a hybrid arrangement of two days in the office and three days remotely each week. Regular hours are Monday through Friday, 8:00 a.m. to 4:30 p.m. CCMSI describes itself as a privately owned third-party administrator (TPA) and a certified Great Place to Work. It emphasizes employee ownership, collaboration, client service, integrity, accountability, and career development. Success is measured through quality claim handling, compliance and audit performance, timeliness and accuracy, client partnership, professional judgment, and cultural alignment.
Requirements
- At least 2 years of workers' compensation claims experience or related insurance industry experience.
- Working knowledge of workers' compensation claim-handling practices and claim life-cycle management.
- Ability to independently manage a full caseload of moderate-complexity claims.
- Strong verbal and written communication skills.
- Excellent organizational skills and ability to prioritize multiple responsibilities.
- Proficiency with Microsoft Office applications, including Outlook, Word, and Excel.
- Ability to work effectively in a collaborative, client-focused environment.
- Reliable and predictable attendance during established business hours.
- Experience handling Missouri workers' compensation claims.
Nice To Haves
- Associate’s degree or higher, or related insurance industry experience.
- Bilingual Spanish proficiency; valued for communicating with claimants, employers, or vendors, but not required.
- Experience handling Illinois workers' compensation claims.
- Experience working in a TPA, carrier, or self-insured claims environment.
Responsibilities
- Investigate and adjust workers' compensation claims according to established procedures and CCMSI guidelines, under direct supervision.
- Review medical, legal, and miscellaneous invoices to determine whether they are reasonable and related to ongoing claims.
- Negotiate disputed bills to reach resolution.
- Authorize and issue workers' compensation claim payments using a claim payment program, within settlement authority and in accordance with industry standards.
- Negotiate settlements with claimants and attorneys in accordance with client authorization.
- Assist with selecting and supervising defense attorneys.
- Assess and monitor subrogation claims toward resolution.
- Prepare reports detailing claims, payments, and reserves.
- Provide reports to excess insurers and monitor files as required.
- Meet team service commitments and deliver quality claim service to clients.
- Communicate proactively with clients and follow through on claim matters.
- Maintain thorough investigations, documentation, and well-supported claim decisions while complying with jurisdictional and client standards.
Benefits
- Four weeks of paid time off and 10 paid holidays in the first year.
- Medical, dental, vision, life, and disability insurance.
- 401(k) retirement plan.
- Employee Stock Ownership Plan (ESOP).
- Internal training and advancement opportunities.
- Supportive, team-based work environment.
- Role may qualify for bonuses or additional forms of pay.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
