Workers' Compensation Claims Adjuster (Hybrid - Phoenix, AZ)

Ccmsi • Phoenix, AZ

8d • Hybrid

About The Position

CCMSI is seeking an experienced Workers' Compensation Claim Consultant to manage Arizona workers' compensation claims for a dedicated municipal client. This is a hands-on claims adjusting role responsible for the investigation, evaluation, administration, and resolution of moderate to high-complexity workers' compensation claims within Arizona jurisdiction. The ideal candidate brings extensive workers' compensation claims experience, strong organizational and time management skills, and the ability to independently manage competing priorities while delivering exceptional client service. This hybrid position requires onsite attendance during the first two weeks of training, followed by a schedule that includes one day per week in the office. This is a full life‑cycle WC adjuster position within a TPA environment, and only candidates with proven Workers’ Compensation claims experience will be considered.

Requirements

• Five or more years of Workers’ Compensation claims experience.
• Current Arizona Adjuster Authorization (ICA AZ Adjuster Authorization).
• Arizona claims handling experience.
• Ability to effectively manage priorities and maintain strong organizational practices.
• Strong written and verbal communication skills.
• Ability to work in a hybrid environment, including onsite training and periodic in-office attendance.

Nice To Haves

• Experience handling municipal or public-sector accounts.
• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.

Responsibilities

• Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
• Establish reserves and/or provide reserve recommendations within established reserve authority levels.
• Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims.
• Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
• Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
• Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
• Assess and monitor subrogation claims for resolution.
• Review and maintain personal diary on claim system.
• Client satisfaction.
• Prepare reports detailing claim status, payments and reserves, as requested.
• Compute disability rates in accordance with state laws.
• Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
• Prepare newsletter articles, as requested.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Handle more complex and involved claims than lower level claim positions with minimum supervision.
• Conduct claim reviews and/or training sessions for designated clients, as requested.
• Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

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: Mid Level
• Education Level: No Education Listed