Workers' Compensation Claim Representative I
Ccmsi•Reno, NV
•Hybrid
About The Position
The Nevada 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.
- Experience handling Nevada Lost Time Claims
- 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 Nevada or ability to obtain one.
Nice To Haves
- Associate’s degree or higher, or related insurance industry experience.
- Past experience handling transportation and construction accounts
- 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
- Medical, Dental, Vision, Life, and Disability Insurance
- 401(k) and Employee Stock Ownership Plan (ESOP)
- Internal training and advancement opportunities
- A supportive, team-based work environment
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
