Workers’ Compensation Claim Specialist
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. As a Workers’ Compensation Claim Specialist , you’ll manage a caseload of mostly litigated and complex claims from start to finish (“cradle to grave”). You’ll ensure timely benefit payments, coordinate medical treatment through MMI, evaluate reserves, and pursue fair settlements and closure. You’ll also work closely with our client to provide exceptional claim outcomes and uphold CCMSI’s commitment to quality and compliance. ⚠️ Please Note: This is an experienced insurance adjusting position. It is not an HR, consultant, or risk management role. We’re seeking a skilled California workers’ compensation adjuster experienced in litigated and complex claims. Applicants without hands-on adjusting experience will not be considered .
Requirements
- Proven experience handling California jurisdiction workers’ compensation claims (litigated and/or complex).
- Strong communication, organization, and time management skills.
- Analytical mindset with sound judgment and decision-making.
- Proficiency in Microsoft Word and Excel.
Nice To Haves
- SIP designation (or willingness to obtain).
- AIC, ARM, or CPCU certification a plus.
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
- Candidates with less experience may be considered at a lower range within the posted salary band.
Responsibilities
- Investigate, evaluate, and adjust California workers’ compensation claims in accordance with CCMSI standards and state laws.
- Manage medical treatment plans and ensure benefits are paid timely and accurately.
- Evaluate claim reserves and settlement potential; negotiate settlements within authority and client guidelines.
- Collaborate effectively with clients, attorneys, medical providers, and internal partners.
- Maintain accurate and timely claim documentation and diary management.
- Participate in regular file reviews and provide thoughtful updates to the client.
- Contribute to a supportive, high-performing team culture rooted in employee ownership.
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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
1,001-5,000 employees
