Workers' Compensation Claim Rep I
About The Position
At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don’t just process claims—we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work®, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. The Workers' Compensation Claim Representative I is responsible for the investigation and adjustment of assigned workers compensation claims. This position may be used as an advanced training position for future consideration for promotion to a Work Comp Claim Rep II or more senior level claim position. Accountable for the quality of claim services as perceived by CCMSI clients and within our corporate claim standards.
Requirements
- 3+ years of Nevada Workers’ Compensation claims experience or related insurance industry experience.
- Strong organizational skills with the ability to prioritize and manage multiple tasks independently.
- Effective verbal and written communication skills for interaction with internal teams, clients, and external partners.
- Ability to work collaboratively in a fast-paced, changing environment while maintaining accuracy and confidentiality.
- Reliable and predictable attendance during established hours.
- Proficiency with Microsoft Office applications (Word, Excel, Outlook).
- Active adjuster license in [State/Jurisdiction] or ability to obtain required licensing for [Jurisdiction(s)] within [X] days of hire, if applicable.
- Experience supporting Tranportation and Contruction type Workers’ Compensation claims.
Nice To Haves
- Associate’s degree or higher, or related insurance indusstry experience.
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
Responsibilities
- Investigate and adjust workers compensation claims in accordance with established claims handling procedures using CCMSI guidelines and direct supervision.
- Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing workers compensation claims.
- Negotiate any disputed bills for resolution.
- Authorize and make payment of workers compensation claims utilizing a claim payment program in accordance with industry standards and within settlement authority.
- Negotiate settlements with claimants and attorneys in accordance with client's authorization.
- Assist in selection and supervision of defense attorneys.
- Assess and monitor subrogation claims for resolution.
- Prepare reports detailing claims, payments and reserves.
- Provide reports and monitor files, as required by excess insurers.
- Compliance with Service Commitments as established by team.
- Delivery of quality claim service to clients.
Benefits
- 4 weeks PTO + 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
Entry Level
Education Level
No Education Listed
Number of Employees
1-10 employees
