Workers’ Compensation Claim Specialist, Senior

Ccmsi • Phoenix, AZ

1d • Hybrid

About The Position

The Workers’ Compensation Claim Specialist, Senior is position is responsible for the investigation and adjustment of workers’ compensation assigned claims. This position may be used as an advanced training position for consideration for promotion to a supervisory/management position. The Workers’ Compensation Claim Specialist, Senior is also accountable for the quality of workers’ compensation claim services as perceived by CCMSI clients and within our corporate claim standards.

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.
• 15 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)
• Internal training and advancement opportunities

What This Job Offers

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