CCMSI · 2 hours ago
Workers’ Compensation Claim Rep I (CA Expertise Required)
San Diego County, CA
Full-time
Hybrid
Entry Level
$60K/yr - $70K/yr
1+ years expCCMSI is a global leader in risk management solutions, seeking a Workers’ Compensation Claim Representative I to handle California workers’ compensation claims. The role involves investigating claims, managing medical and legal activities, and ensuring compliance with regulations while providing excellent service to clients.
Financial ServicesInsuranceRetail
No H1B
Responsibilities
Investigate and adjust California workers’ compensation claims in accordance with CCMSI standards and client handling instructions
Manage claims cradle-to-grave, including compensability decisions, medical management, and resolution strategy
Review medical, legal, and miscellaneous invoices for accuracy, reasonableness, and claim-relatedness
Negotiate disputed medical bills and work toward timely resolution
Authorize and issue claim payments within assigned settlement authority
Communicate with injured workers, employers, attorneys, medical providers, and internal partners
Assist with settlement negotiations in accordance with client authorization
Support the selection and coordination of defense counsel as appropriate
Evaluate and monitor subrogation opportunities
Prepare claim reports, payment summaries, and reserve documentation
Maintain compliance with service commitments, jurisdictional requirements, and excess reporting obligations
Deliver consistent, high-quality claim service aligned with CCMSI’s corporate standards
Qualification
Required
1–3 years of workers' compensation claims experience or related experience in insurance, medical claims, legal, or adjacent claim-support roles
Working knowledge of the California workers' compensation claims process
Strong organizational, communication, and time-management skills
Ability to prioritize work, meet deadlines, and manage multiple tasks
Reliable, predictable attendance within established client service hours
Preferred
SIP designation or ability to obtain within a defined timeframe
Associate degree or higher
Experience supporting PEO and/or staffing accounts
Proficiency with Microsoft Word, Excel, Outlook, and claims systems
Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required
Benefits
4 weeks PTO + 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
Company
CCMSI
CCMSI is a third-party administrator for workers' compensation and property/casualty self-insurance programs.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
G
G. Bryan G. Bryan Thomas
President/CEO
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