Workers' Compensation Claim Representative II

Ccmsi • Phoenix, AZ

2d • Hybrid

About The Position

We are seeking an experienced Workers’ Compensation Claim Representative II to manage a caseload of active indemnity claims with strong technical expertise and sound judgment. This role requires 5–10 years of experience and an active ICA Adjuster Authorization. You will be dedicated to a single municipal account, handling investigations, compensability decisions, and claim resolution while delivering excellent client service. The position offers an opportunity to further develop your skills and grow into more senior claim roles, while upholding CCMSI’s high standards for quality and performance.

Requirements

• Excellent oral and written communication skills.
• Self‑starter with strong organizational skills and the ability to work with minimal supervision.
• Proven 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, both verbally and in writing.
• 5 to 10 years of Workers’ Compensation claims management experience or equivalent combination of experience and education.
• Proficiency with Microsoft Office programs (Word, Excel, Outlook, etc.).
• AZ Adjuster’s license and ICA Adjuster Authorization is required (or must be able to obtain).

Nice To Haves

• Associate degree is preferred but not required.
• 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 (Paid time off that accrues throughout the year in accordance with company policy)
• 10 paid holidays in your first year
• Medical, Dental, Vision, Life, and Disability Insurance
• 401(k) and Employee Stock Ownership Plan (ESOP)

What This Job Offers

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