Texas Work Comp Insurance Adjuster

Ccmsi•Dallas, TX

5d•Remote

About The Position

CCMSI is seeking an experienced Workers’ Compensation Claim Representative II to manage a portfolio of Texas workers’ compensation claims across multiple accounts and industries. The role handles moderately complex claims, including investigation, compensability decisions, and timely resolution, while providing professional, empathetic service to injured workers and clients. The position is remote from day one and reports remotely from Dallas, Texas. The stated schedule is 8:00 a.m. to 4:30 p.m. Central Time. The salary range is $68,000–$78,000, depending on experience; the role may also qualify for bonuses or other forms of pay. The representative works under established claim-handling procedures, CCMSI guidelines, and direct supervision. The role involves reviewing and negotiating invoices, authorizing payments and settlements within applicable authority, coordinating with attorneys, monitoring subrogation and excess-insurer files, and preparing claims reports. Success is measured through quality claim handling, compliance, timeliness and accuracy, client partnership, professional judgment, and cultural alignment. CCMSI describes itself as the largest privately owned third-party administrator and a certified Great Place to Work. It emphasizes employee ownership, career development, collaboration, and a supportive, team-based culture. CCMSI does not provide visa sponsorship for this position.

Requirements

Texas Adjusting License is required.
At least 5 years of Texas workers’ compensation claims management experience, or an equivalent combination of experience and education.
Excellent oral and written communication skills.
Self-starter with strong organizational skills and the ability to work with minimal supervision.
Ability to coordinate, prioritize, and manage multiple responsibilities.
Flexibility, initiative, and adaptability in a fast-paced, rapidly changing environment.
Strong discretion and ability to maintain confidentiality.
Ability to work effectively as part of a team.
Reliable, predictable attendance within client service hours.
Responsiveness to internal and external client needs.
Ability to communicate clearly and professionally, verbally and in writing.
Proficiency with Microsoft Office programs, including Word, Excel, and Outlook.

Nice To Haves

Associate degree preferred but not required.
Spanish bilingual proficiency is highly valued 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 to reach resolution.
Authorize and pay workers’ compensation claims using a claim payment program, within settlement authority and in accordance with industry standards.
Negotiate settlements with claimants and attorneys in accordance with client authorization.
Assist in selecting and supervising defense attorneys.
Assess and monitor subrogation claims through resolution.
Prepare reports detailing claims, payments, and reserves.
Provide reports and monitor files as required by excess insurers.
Meet service commitments established by the team and deliver quality claim service to clients.
Maintain thorough investigations, strong documentation, supported decisions, compliance with jurisdictional and client standards, timely file progress, proactive client communication, and professional judgment.

Benefits

Four weeks of paid time off in the first year, accruing throughout the year in accordance with company policy.
10 paid holidays in the first year.
Medical insurance.
Dental insurance.
Vision insurance.
Life insurance.
Disability insurance.
401(k) retirement plan.
Employee Stock Ownership Plan (ESOP).
Internal training and advancement opportunities.
Supportive, team-based work environment.