Workers' Compensation Claim Representative II

Ccmsi • Las Vegas, NV

19h • Hybrid

About The Position

Workers' Comp Claim Adjuster II (Hybrid) - Nevada Location: Las Vegas, NV Schedule: 8:00am - 4:30pm (PST) Salary Range: Build Your Career With Purpose at CCMSI 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. Job Summary Responsible for conducting thorough investigations and administering assigned workers’ compensation claims. This role also serves as a development position with potential advancement into senior‑level claims roles. Ensures high‑quality claim handling in accordance with CCMSI’s corporate standards and the service expectations of our clients. Please note: This is not an HR, administrative, consulting, or advisory support role. This is a true adjusting position. Candidates must have proven experience conducting full investigation, evaluation, negotiation, and resolution of workers’ compensation claims, with end-to-end file ownership and decision-making authority. Applicants without direct claims adjusting experience will not be considered.

Requirements

• Excellent oral and written communication skills.
• Self‑starter with strong organizational skills and the ability to coordinate and prioritize tasks effectively.
• Demonstrated flexibility, initiative, and ability to work with minimal direct supervision.
• Ability to maintain discretion and confidentiality at all times.
• Strong teamwork skills and the ability to work effectively in a fast‑paced, changing environment.
• Reliable and predictable attendance during client service hours.
• Responsiveness to internal and external client needs.
• Ability to communicate clearly and professionally, both verbally and in writing.
• 5–10 years of experience in claims handling or equivalent education, with proven performance in claims management.

Nice To Haves

• Billingual (Spanish) proficiency- highly cvalued for communicating (written and verbal) with claimants, employers, or vendors, but not required.
• Prior experience with Nevada- only WC claim handling
• Professional designations such as AIC, ARM, or CPCU

Responsibilities

• Investigate and adjust workers’ compensation claims in accordance with CCMSI procedures, industry standards, and supervisor guidance.
• Review medical, legal, and related invoices to confirm reasonableness and claim relevance; negotiate disputed bills as needed.
• Authorize and process claim payments using approved systems, ensuring accuracy and adherence to settlement authority levels.
• Negotiate claim settlements with injured workers and attorneys in alignment with client authorization and company guidelines.
• Assist in selecting, directing, and monitoring defense counsel.
• Evaluate and track subrogation opportunities to support recovery efforts.
• Prepare detailed reports on claim activity, payments, and reserve recommendations.
• Provide required reporting and file monitoring for excess insurance carriers.
• Meet established team service commitments and performance standards.
• Deliver high‑quality claim service and maintain strong client relationships.

Benefits

• 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 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: No Education Listed