Workers' Compensation Claim Consultant

Ccmsi • Scottsdale, AZ

10d • $75,000 - $85,000 • Hybrid

About The Position

CCMSI is seeking an experienced Arizona Workers’ Compensation Claim Consultant to manage a complex portfolio of claims in a third-party administrator environment. This is a full life-cycle workers’ compensation adjuster role requiring proven claims experience, with responsibility for investigating claims, guiding claim strategy, and achieving fair and timely resolutions. The consultant will handle more complex claims than lower-level claim positions, with minimal supervision, and will provide responsive service to clients while supporting injured workers. The role offers a development pathway toward more senior claim positions.

The position is based in Scottsdale, Arizona, with a Monday–Friday schedule from 8:00 a.m. to 4:30 p.m. (MDT). A hybrid schedule is available after initial training. The stated salary range is $75,000–$85,000, depending on experience; the role may also qualify for bonuses or other forms of pay. CCMSI describes itself as the largest privately owned third-party administrator and an employee-owned company, and identifies itself as a certified Great Place to Work®.

Requirements

• At least 5 years of Arizona Workers’ Compensation claims experience.
• Ability to investigate and handle Arizona lost-time claims with little supervision.
• Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
• An adjuster’s license may be required, depending on jurisdiction.

Nice To Haves

• Bachelor’s degree preferred but not required.
• Experience handling healthcare claims is a plus.
• Bilingual Spanish proficiency is highly valued but 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 for reasonableness and relation to claims; negotiate disputed bills or invoices.
• Authorize and make claim payments in accordance with procedures, industry standards, and payment authority.
• Negotiate settlements in accordance with corporate standards, client instructions, and state laws, when appropriate.
• Assist with selection, referral, and supervision of claim files sent to outside vendors, including legal, surveillance, and case-management vendors.
• Assess and monitor subrogation claims through resolution.
• Review and maintain a personal diary in the claim system.
• Support client satisfaction.
• Prepare reports on claim status, payments, and reserves as requested.
• Compute disability rates in accordance with state laws.
• Coordinate timely communication with clients, claimants, and appropriate parties throughout the claim adjustment process.
• Prepare newsletter articles as requested.
• Provide notice of qualifying claims to excess or reinsurance carriers.
• Handle complex claims with minimal supervision.
• Conduct claim reviews or training sessions for designated clients as requested.
• Attend and participate in hearings, mediations, and informal legal conferences as appropriate.
• Comply with corporate claim-handling standards and special client handling instructions.
• Uphold quality claim handling, sound documentation, compliance, timely file movement, proactive client communication, and professional judgment.

Benefits

• Four weeks of paid time off, accrued throughout the year in accordance with company policy.
• 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.
• 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