Spanish Bilingual CA Workers' Compensation Adjuster

Ccmsi • Irvine, CA

7d

About The Position

CCMSI is seeking an experienced Workers’ Compensation Claim Consultant to manage a dedicated client portfolio of complex California workers’ compensation claims. This is a full life-cycle adjuster position in a third-party administrator environment, requiring proven workers’ compensation claims experience and the ability to handle litigated claims from inception through resolution. The consultant will conduct investigations, develop and execute claim strategies, and pursue fair, timely resolutions while providing responsive service to clients and supporting injured workers. The role offers a development pathway to more senior claim positions.

The position is based in Irvine, California. The employee must be able to attend training in the office and an annual client meeting. The stated schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m. The salary range is $70,500–$90,500, depending on experience; the role may also qualify for bonuses or additional forms of pay.

CCMSI describes itself as the largest privately owned third-party administrator and a certified Great Place to Work. It offers a supportive, team-based environment, internal training and advancement opportunities, and an employee-ownership culture. The company does not provide visa sponsorship and is committed to reasonable accommodations and equal employment opportunity.

Requirements

• At least 5 years of California workers’ compensation claims experience.
• Active California Workers’ Compensation Adjuster license.
• Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
• Demonstrated experience handling litigated claims from inception through resolution.
• Proven workers’ compensation claims experience; candidates without it will not be considered.

Nice To Haves

• Bachelor’s degree preferred, but not required.
• Experience handling high-complexity workloads (the posting states “2+ Experience”).
• Spanish bilingual proficiency is highly valued for communicating with claimants, employers, or vendors, but is not required.

Responsibilities

• Investigate, evaluate, and adjust claims in accordance with claim-handling standards and applicable laws.
• Establish reserves or provide reserve recommendations within established authority levels.
• Review, approve, or oversee medical, legal, damage-estimate, and miscellaneous invoices to determine whether they are reasonable and related to claims; negotiate disputed bills or invoices.
• Authorize and make claim payments according to procedures, industry standards, and established payment authority.
• Negotiate settlements in accordance with corporate claim standards, client-specific instructions, and state laws, when appropriate.
• Assist in selecting, referring, and supervising outside vendors, such as legal, surveillance, and case-management providers.
• Assess and monitor subrogation claims through resolution.
• Review and maintain a personal diary in the claim system.
• Support client satisfaction and prepare requested reports detailing claim status, payments, and reserves.
• Compute disability rates in accordance with state laws.
• Coordinate timely communications with clients, claimants, and other appropriate parties throughout the adjustment process.
• Prepare newsletter articles when requested.
• Provide notices of qualifying claims to excess or reinsurance carriers.
• Handle complex claims with minimal supervision.
• Conduct claim reviews or training sessions for designated clients when requested.
• Attend and participate in hearings, mediations, and informal legal conferences as appropriate.
• Comply with corporate claim-handling standards and special client instructions.
• Demonstrate thorough investigations, strong documentation, well-supported decisions, compliance, timely file movement, proactive client communication, professional judgment, and ownership of claim outcomes.

Benefits

• Four weeks of paid time off in the first year, accruing throughout the year in accordance with company policy.
• 10 paid holidays in the first year.
• Medical insurance.
• Dental insurance.
• Vision insurance.
• Life insurance.
• Disability insurance.
• 401(k) retirement plan.
• Employee Stock Ownership Plan (ESOP).
• Internal training and advancement opportunities.
• Supportive, team-based work environment.
• Potential eligibility for bonuses or additional forms of pay.

What This Job Offers

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