Workers' Compensation Claim Adjuster (Hybrid) (Blended Desk - Medical and Indemnity)

CCMSI • Dublin, OH, US • 2w ago

Overview

Workers’ Compensation Claim Adjuster - Lost Time and Medical Only

Location: Dublin, OH (Hybrid after training – will consider remote for the right candidate)Schedule: Monday–Friday, 8:00 AM to 4:30 PMSalary Range: $60,000 – $65,000 annually

After two weeks of in-office training, you’ll transition to a hybrid schedule (two days in the office, three days at home). For experienced candidates with strong Ohio jurisdiction knowledge, a remote option may be considered.

Build Your Career With Purpose at CCMSI

At CCMSI, we don’t just process claims—we support people. As one of the largest employee-owned Third Party Administrators in the country, CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work®, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.

Job Summary

This role is responsible for the investigation, management, and resolution of both medical-only and lost-time Workers’ Compensation claims, ensuring compliance with Ohio state laws and CCMSI’s best practices. You’ll serve as the primary point of contact for your assigned client, delivering high-quality claim service, timely communication, and accurate documentation throughout the life of each claim.

Performance is measured by Best Practice scores, audit results, and client feedback.

Important Note:This position is not an HR, medical billing, or administrative role. It is a professional claim adjusting position requiring prior experience managing Workers’ Compensation claims, preferably within a Third-Party Administrator (TPA) environment.

Responsibilities

Investigate, evaluate, and adjust Medical Only and Lost Time Workers’ Compensation claims in accordance with Ohio BWC and CCMSI guidelines.
Establish reserves and authorize payments within assigned authority levels.
Review, approve, and negotiate medical and legal expenses as appropriate.
Evaluate medical documentation, determine compensability, and manage return-to-work efforts.
Negotiate settlements with claimants, attorneys, and other stakeholders as authorized.
Coordinate and communicate with defense counsel, medical providers, and employer representatives.
Monitor and pursue subrogation opportunities.
Prepare detailed and timely claim documentation, reports, and updates for both clients and excess carriers.
Participate in periodic in-state travel for client claim reviews and meetings.

Qualifications

Required:

Experience handling both Medical Only and Lost Time Workers’ Compensation claims.
Strong understanding of Ohio Workers’ Compensation laws, regulations, and forms.
Excellent organizational, communication, and analytical skills.
Proficiency with Microsoft Office and claims management software.
Ability to manage a caseload independently while collaborating with the team.

Preferred:

Prior experience handling claims for medical or healthcare industry clients.
Experience working in a Third-Party Administrator (TPA) environment.
2+ years of Workers’ Compensation adjusting experience.
Associate degree or equivalent experience.

Training & Development

Two weeks of structured in-office training followed by ongoing, hands-on mentorship.

How We Measure Success

Accuracy and timeliness of claim handling and documentation.
Quality of claim file audits and annual performance reviews.
Positive client feedback and adherence to service standards.

What We Offer

4 weeks PTO + 10 paid holidays in your first year• Medical, Dental, Vision, Life, and Disability Insurance• 401(k) and Employee Stock Ownership Plan (ESOP)• Internal training and advancement opportunities• A supportive, team-based work environment

Compensation & Compliance

The posted salary reflects CCMSI’s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity.

Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.

Our Core Values

At CCMSI, we believe in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who:• Act with integrity• Deliver service with passion and accountability• Embrace collaboration and change• Seek better ways to serve• Build up others through respect, trust, and communication• Lead by example—no matter their title

We don’t just work together—we grow together. If that sounds like your kind of workplace, we’d love to meet you.

#EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #LI-Hyrbid

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