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CCMSI · 2 weeks ago

Workers’ Compensation Claim Specialist – Dedicated Account (California Jurisdiction | Remote)

United States

Full-time

Remote

Mid, Senior Level

$87K/yr - $97K/yr

CCMSI is a leading employee-owned Third Party Administrator specializing in risk management solutions. As a Workers’ Compensation Claim Specialist, you will manage a caseload of complex claims, ensuring timely benefit payments and collaborating with clients to achieve exceptional outcomes.

Financial ServicesInsuranceRetail

No H1B

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

Qualification

California workers' compensation claimsLitigated claims experienceComplex claims experienceMicrosoft WordMicrosoft ExcelAnalytical mindsetSound judgmentSIP designationAIC certificationARM certificationCPCU certificationBilingual (Spanish)Communication skillsOrganization skillsTime management skillsDecision-making