Nevada Work Comp Insurance Adjuster

Ccmsi • Reno, NV

5d

About The Position

The Workers' Compensation Claim Representative I investigates and adjusts assigned workers' compensation claims, following established claim-handling procedures, CCMSI guidelines, and direct supervision. The role is accountable for the quality of claim services as perceived by clients and for meeting corporate claim standards. It may serve as an advanced training position for potential promotion to Claim Representative II or a more senior claims role.

The representative reviews and negotiates medical, legal, and miscellaneous invoices; authorizes and pays claims within settlement authority; negotiates settlements with claimants and attorneys under client authorization; and supports the selection and supervision of defense attorneys. The role also monitors subrogation, prepares claim and reserve reports, provides reporting to excess insurers, and meets team service commitments while delivering quality client service.

Requirements

• At least 3 years of Nevada workers' compensation claims experience or related insurance industry experience.
• Strong organizational skills, including 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 collaborate 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 Nevada adjuster license.

Nice To Haves

• Associate's degree or higher, or related insurance industry experience.
• Bilingual Spanish proficiency; valued for communicating with claimants, employers, or vendors, but not required.

Responsibilities

• Investigate and adjust workers' compensation claims according to established procedures, CCMSI guidelines, and direct supervision.
• Review medical, legal, and miscellaneous invoices to determine whether they are reasonable and related to ongoing claims.
• Negotiate disputed bills for resolution.
• Authorize and make workers' compensation claim payments using 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 to excess insurers and monitor files as required.
• Comply with team service commitments and deliver quality claim service to clients.

Benefits

• Four weeks of PTO and 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.
• Role may qualify for bonuses or additional forms of pay.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed