Apply on Employer Site

CCMSI · 2 months ago

Senior Workers’ Compensation Adjuster – Remote (CA Jurisdiction)

United States

Full-time

Remote

Senior Level, Lead/Staff

$85K/yr - $97K/yr

10+ years exp

CCMSI is one of the nation’s leading Third Party Administrators in self-insurance services, and they are seeking an experienced California Workers’ Compensation Claim Specialist to join their remote team. This position is responsible for investigating, evaluating, and resolving complex California workers’ compensation claims in accordance with best practices and state regulations.

Financial ServicesInsuranceRetail

No H1B

Responsibilities

Investigate, evaluate, and adjust workers’ compensation claims within California jurisdiction in compliance with applicable laws and CCMSI standards

Establish and maintain appropriate reserves; authorize or recommend reserves and payments within assigned authority levels

Review, negotiate, and approve medical, legal, and other invoices as appropriate

Coordinate communication among claimants, clients, attorneys, and medical professionals to ensure timely and effective claim resolution

Attend and participate in hearings, mediations, and legal conferences as required

Prepare and maintain accurate, detailed claim documentation in compliance with corporate and client requirements

Monitor subrogation and excess/reinsurance claims as applicable

Deliver high-quality, client-focused service aligned with CCMSI’s commitment to excellence

Qualification

California workers' compensation claimsCalifornia WC statutes knowledgeSIP certificationAIC designationThird Party Administrator experienceMultitasking abilitiesMicrosoft Office proficiencyWritten communicationVerbal communicationOrganization skillsTime management