Workers' Compensation Claim Representative II

Ccmsi • Reno, NV

2d • Hybrid

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 role for future consideration for promotion to a Work Comp Claim Representative II or more senior-level claim position. The Claim Representative I manages a reasonable caseload of indemnity claims of moderate to high complexity, with exposure to both non-litigated and litigated matters, including a moderate to heavy percentage of litigated claims. Assigned claims span multiple client accounts and are handled within the Nevada jurisdiction. This role is accountable for delivering quality claim services as perceived by CCMSI clients while adhering to 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 Nevada or ability to obtain required licensing
• Experience supporting multiple accounts, indemnity claims, and litigated Workers’ Compensation claims.

Nice To Haves

• Associate’s degree or higher, or related insurance industry 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree