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CCMSI · 2 hours ago

Workers’ Compensation Claims Adjuster (MI focus)

Okemos, MI

Full-time

Hybrid

Mid, Senior Level

$60K/yr - $80K/yr

5+ years exp

CCMSI is a leading Third Party Administrator (TPA) specializing in risk management solutions. The Workers’ Compensation Claims Consultant is responsible for investigating, evaluating, and adjusting Michigan workers’ compensation claims while ensuring compliance with state laws and company standards.

Financial ServicesInsuranceRetail

No H1B

Responsibilities

Investigate, evaluate, and adjust Michigan workers’ compensation claims in compliance with state laws and CCMSI standards

Establish and manage reserves within authority levels; escalate as needed

Review and approve medical, legal, and miscellaneous invoices; negotiate disputed bills

Authorize and process claim payments within established guidelines

Negotiate settlements in accordance with corporate standards and state regulations

Coordinate with outside vendors (legal, surveillance, case management) as needed

Monitor subrogation claims and pursue recovery opportunities

Maintain accurate documentation and diary entries in the claim system

Communicate effectively with clients, claimants, and internal teams throughout the claim process

Prepare reports detailing claim status, payments, and reserves

Attend hearings, mediations, and legal conferences as required

Qualification

Workers’ compensation experienceMichigan Workers’ Compensation ActAdjuster’s license (Michigan)Investigation skillsMicrosoft Office proficiencyNegotiation skillsMultitasking skillsBachelor’s degreeClaims in multiple jurisdictionsBilingual (Spanish)