New Mexico Work Comp Insurance Adjuster

Ccmsi•Albuquerque, NM

1d•Hybrid

About The Position

The Workers' Compensation Claim Representative I investigates, administers, and adjusts assigned workers' compensation claims across multiple client accounts in New Mexico. The position manages claims through the full life cycle, from initial report through closure, and is accountable for delivering quality claim services in accordance with CCMSI standards and client commitments. The role operates with direct supervision and may serve as an advanced training opportunity for promotion to a Claim Representative II or another senior-level claims position. The ideal candidate has experience managing moderately complex claims, including investigation, compensability determinations, benefit administration, reserve management, return-to-work coordination, and claim resolution. The position is based in Albuquerque and follows a Monday–Friday, 8:00 a.m.–4:30 p.m. schedule, with a hybrid schedule available after initial training.

Requirements

At least 3 years of workers' compensation claims experience or related insurance industry experience.
Strong organizational skills and the ability to prioritize and independently manage multiple tasks.
Effective verbal and written communication skills for interactions 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 work hours.
Proficiency with Microsoft Office applications, including Word, Excel, and Outlook.
Active New Mexico Adjusters License.

Nice To Haves

Experience supporting workers' compensation claims across various industries.
Associate's degree or higher, or related insurance industry experience.
Bilingual Spanish proficiency; highly valued but not required.

Responsibilities

Investigate and adjust workers' compensation claims in accordance with established procedures, CCMSI guidelines, and direct supervision.
Review medical, legal, and miscellaneous invoices to determine whether they are reasonable and related to ongoing claims, and negotiate disputed bills for resolution.
Authorize and issue workers' compensation claim payments through a claim payment program, in accordance with industry standards and settlement authority.
Negotiate settlements with claimants and attorneys in accordance with client authorization.
Assist in selecting and supervising 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.
Meet team service commitments and deliver quality claim service to clients.