SIP-Certified Workers' Compensation Adjuster (Remote)

Ccmsi • Concord, CA

13d • Remote

About The Position

The Senior Workers' Compensation Claims Adjuster is responsible for the investigation, evaluation, administration, and resolution of California Workers' Compensation claims across multiple client programs. This role manages claims from assignment through closure while ensuring compliance with California workers' compensation laws, client-specific handling instructions, and CCMSI claim handling standards. The ideal candidate is an experienced California adjuster who understands how to manage an active inventory, navigate litigated files, make sound claim decisions, and communicate confidently with injured workers, attorneys, medical providers, and clients. Most importantly, we're looking for someone who thrives in a culture built on accountability, collaboration, and trust. Our best adjusters are self-starters who take ownership of their files, communicate proactively, and consistently deliver high-quality claim outcomes.

Requirements

• California Workers' Compensation claims handling experience
• Self-Insured Administrator Certificate (SIP) required
• Strong understanding of California Workers' Compensation laws and regulations
• Experience handling litigated Workers' Compensation claims
• Experience managing claims from investigation through resolution
• Ability to independently manage a full caseload
• Strong reserve management and claim strategy skills
• Excellent verbal and written communication skills
• Strong negotiation and problem-solving abilities
• Ability to work independently in a remote environment
• Proficiency with Microsoft Office applications
• Reliable attendance during established business hours

Nice To Haves

• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
• Prior TPA experience is helpful
• Experience presenting files during client claim reviews is helpful
• Professional designations such as AIC, ARM, or CPCU are preferred but not required

Responsibilities

• Investigate, evaluate, and adjust California Workers' Compensation claims from assignment through resolution
• Manage indemnity and medical exposures while developing effective claim strategies
• Handle litigated claims and collaborate with defense counsel throughout the litigation process
• Determine compensability and establish appropriate reserves
• Coordinate medical treatment, return-to-work efforts, and vocational considerations when applicable
• Monitor claim activity and ensure timely file movement and diary management
• Evaluate settlement opportunities and negotiate claim resolutions within authority
• Communicate regularly with injured workers, employers, attorneys, medical providers, and clients
• Maintain accurate file documentation and claim reporting
• Participate in claim reviews and client meetings as requested
• Ensure compliance with California Workers' Compensation regulations and client handling requirements

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: Senior
• Education Level: No Education Listed