Overview
Workers' Compensation Claim SpecialistRemote Role Reporting to Concord, CA BranchSalary: $85,000 - $100,000 (based on experience)Work Schedule: Monday to Friday, 8:00 AM to 4:30 PM (with potential for flexible hours)
Disclaimer: The posted salary range for this position reflects the anticipated base pay for this role. Actual pay is determined based on factors such as qualifications, skills, relevant experience, internal equity, and location. Additional compensation may include discretionary bonuses, benefits, or other forms of compensation, depending on the role. The salary range provided is in compliance with state and local requirements and is intended to offer transparency to applicants. We encourage open discussions with our hiring team regarding any questions you may have about compensation and benefits for this position.
CCMSI is an Affirmative Action / Equal Employment Opportunity employer offering an excellent benefits package including Medical, Dental, Prescription Drug, Vision, Flexible Spending, Life, ESOP, and 401K. CCMSI conducts background checks in accordance with applicable federal, state, and local laws.
Administrator (TPA) in self-insurance services, we are driven by a common purpose: delivering exceptional service to our clients. As an Employee-Owned Company, we focus on the development of our team members through structured career programs, and we reward and recognize individual and team contributions. Certified as a Great Place to Work, our employee satisfaction and retention are in the 95th percentile.
Why you should consider a career with CCMSI:
- Culture: Our core values—integrity, passion, and enthusiasm—are embedded in how we treat our employees as valued partners.
- Career Development: We offer robust internships and internal training programs for growth and advancement within our organization.
- Benefits: Enjoy 4 weeks of paid time off in your first year, plus 10 paid holidays, along with Medical, Dental, Vision, Life Insurance, Critical Illness, Disability, 401K, and ESOP.
- Work Environment: We provide a supportive environment where employees have the resources needed to succeed. Claims staff are assigned manageable caseloads.
Job Overview:
The Workers' Compensation Claim Specialist is responsible for the investigation and adjustment of claims across multiple accounts. With a focus on high-quality claim service, this role ensures claims are handled according to CCMSI’s corporate standards and client-specific guidelines. This position is ideal for professionals with 5+ years of experience in California Workers' Compensation and offers potential for advancement to supervisory or management roles.
Responsibilities
- Investigate, evaluate, and adjust claims in line with established claim handling standards and laws.
- Establish reserves and provide reserve recommendations within authority levels.
- Review and approve medical, legal, damage estimates, and miscellaneous invoices, negotiating disputed bills.
- Make claim payments in accordance with procedures and industry standards.
- Negotiate settlements according to corporate and client-specific instructions, while adhering to state laws.
- Supervise external vendors, including legal, surveillance, and case management services.
- Maintain personal diary on the claim system and monitor subrogation claims.
- Communicate effectively and timely with clients, claimants, and relevant parties.
- Adhere to corporate claim handling standards and special client instructions.
- Perform other duties as required.
Qualifications
- Experience: 5+ years of experience in California Workers' Compensation claims handling.
- Licenses: CA Workers' Compensation Certificate or SIP preferred ir required
- Skills:
- Strong knowledge of California Workers' Compensation laws and procedures.
- Excellent oral and written communication skills.
- Analytical and negotiation skills.
- Ability to work with minimal supervision and manage multiple claims effectively.
- Self-starter with strong organizational abilities and attention to detail.
- Flexibility, accuracy, and initiative.
- Ability to work a claim from start to completion.
Travel Requirements: Minimal travel may be required for claim reviews and training.
Physical Demands:The role requires the ability to sit or stand for extended periods, bend, stoop, and perform tasks requiring manual dexterity. Must have sufficient auditory and visual acuity to interact with others.
Core Values & Principles:
Employees are expected to uphold CCMSI’s Core Values and Principles, which include performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.
Ready to Make an Impact?At CCMSI, we’re looking for talented professionals like you to join our team and help us deliver outstanding service to our clients. If you're ready to bring your expertise in Workers' Compensation claims handling to a company that values integrity, career growth, and work-life balance, we want to hear from you.
Apply now to take the next step in your career with an employee-owned company that invests in your future!
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