Workers' Compensation Claims Adjuster (Hybrid)

Ccmsi • Jackson, MS

4d • Hybrid

About The Position

The Workers' Compensation Claim Consultant is responsible for the investigation, evaluation, administration, and resolution of workers' compensation claims across multiple client accounts and industries. This role manages claims from assignment through closure while ensuring compliance with client handling instructions, applicable state laws, and CCMSI's claim handling standards. The successful candidate will handle a diverse inventory of approximately 100–125 claims ranging from low to high complexity, including litigated files. Claims are primarily handled in Mississippi and Alabama, requiring strong technical knowledge of workers' compensation claim practices, regulatory requirements, and effective claim resolution strategies. This position is ideal for an experienced adjuster who can independently manage an active caseload, communicate effectively with injured workers and stakeholders, and consistently deliver high-quality claim outcomes.

Requirements

• Five or more years of Workers’ Compensation claims experience.
• Active MS and/or AL adjusters license
• Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
• Adjuster’s license may be required based on jurisdiction.

Nice To Haves

• Prior TPA experience is helpful
• 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
• 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