Workers' Compensation Claim Consultant
About The Position
We are seeking an experienced and highly skilled California Workers’ Compensation Claim Consultant to manage a complex portfolio of claims with confidence, empathy, and sound professional judgment. With 5+ years of hands-on claims experience, you will lead thorough investigations, guide claim strategy, and ensure fair, timely resolutions. In this role, you will be assigned to a single dedicated client account, allowing you to build strong partnerships, gain in-depth knowledge of the client's program and culture, and deliver exceptional, consistent claim management services. This position also offers a strong development pathway for advancement into more senior claim positions. As a Claim Consultant, you will play a key role in delivering exceptional service to CCMSI clients and upholding our high standards of quality and responsiveness. This is a full life‑cycle WC adjuster position within a TPA environment, and only candidates with proven Workers’ Compensation claims experience will be considered.
Requirements
- Experience handling indemnity and litigated cases.
- 5+ years of handling workers' compensation claims.
- Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
- California adjuster’s license is required.
Nice To Haves
- Bachelor’s degree is preferred but not required.
- Five or more years of California Workers’ Compensation claims experience.
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
- Experience handling waste management cases is a plus!
Responsibilities
- Investigate, evaluate, and manage workers’ compensation claims in compliance with state regulations and company standards.
- Establish reserves, authorize payments, and negotiate settlements within authority levels.
- Coordinate with attorneys, medical providers, case managers, and other vendors to drive claim resolution.
- Monitor claim progress, maintain accurate documentation, and provide timely claim status reports.
- Identify and pursue subrogation opportunities when appropriate.
- Communicate effectively with clients, claimants, and other stakeholders throughout the claim lifecycle.
- Handle complex claims with minimal supervision while maintaining compliance with client-specific handling instructions and corporate standards.
- Participate in claim reviews, hearings, mediations, training sessions, and client meetings as needed.
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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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
