Overview
Workers' Compensation Claim Specialist (Sr. Adjuster)
Compensation: $85,000–$95,000 annually (based on experience)
Schedule: Monday–Friday (PST hours)
Work Model: Fully Remote (reports to Las Vegas branch)
Jurisdiction: California only
Build Your Career With Purpose at CCMSI
At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.
We don’t just process claims—we support people. As the largest privately-owned Third Party Administrator (TPA), 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
We are seeking an experienced Workers’ Compensation Claim Specialist (Sr. Adjuster) to join our team supporting California jurisdiction claims. This is a remote position that reports to our Las Vegas, NV branch, with a Monday–Friday schedule operating in Pacific Standard Time.
As a senior-level adjuster, you will manage a multi‑account desk and handle California workers’ compensation claims from start to finish, including AOE/COE determinations, benefit calculations, proactive communication, and full file resolution. SIP certification or a California Claims Adjuster Certificate is required.
Please note: This is a claims adjuster role responsible for full cradle‑to‑grave claim handling within a TPA environment. It is not an HR, consulting, or employer‑side position.
Responsibilities
When we hire adjusters, we look for professionals who take ownership of their work, navigate complex claims with confidence, and deliver exceptional service with integrity. In this role, you’ll manage your desk independently while contributing to a collaborative, high‑performing team.
What You’ll Do
- Investigate, evaluate, and adjust California workers’ compensation claims in alignment with CCMSI standards and state regulations.
- Make clear and defensible AOE/COE determinations.
- Authorize and issue timely benefit payments, including accurate calculation of Temporary Disability benefits.
- Establish reserves and provide reserve recommendations within authority levels.
- Review, approve, or negotiate medical, legal, and miscellaneous invoices.
- Select, coordinate, and oversee outside vendors (legal, case management, surveillance).
- Negotiate settlements in accordance with state law, client instructions, and handling standards.
- Maintain accurate, complete, and timely diary entries and documentation.
- Compute disability rates in accordance with California statutes.
- Communicate effectively with claimants, clients, providers, and attorneys throughout the claim lifecycle.
- Manage excess reporting requirements when applicable.
- Monitor and pursue subrogation opportunities as appropriate.
Qualifications
What You Bring
Required
- SIP certification or California Workers’ Compensation Claims Adjuster Certificate.
- 10+ years of California workers’ compensation adjusting experience.
- Strong command of CA workers’ compensation statutes, timelines, and benefit calculations.
- Demonstrated ability to manage a multi‑account desk with competing priorities.
- Excellent written and verbal communication skills.
- Proven analytical, investigative, and negotiation skills.
- Strong organizational ability and a high level of accuracy.
- Initiative, dependability, and the ability to work independently with minimal supervision.
- Commitment to confidentiality, client service, and professional integrity.
- Reliable, predictable attendance during PST business hours.
Preferred
Why You’ll Love Working Here
- 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 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
How We Measure Success
At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:
- Quality claim handling – thorough investigations, strong documentation, well-supported decisions
- Compliance & audit performance – adherence to jurisdictional and client standards
- Timeliness & accuracy – purposeful file movement and dependable execution
- Client partnership – proactive communication and strong follow-through
- Professional judgment – owning outcomes and solving problems with integrity
- Cultural alignment – believing every claim represents a real person and acting accordingly
This is where we shine, and we hire adjusters who want to shine with us.
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. This role may also qualify for bonuses or additional forms of pay.
CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance.
Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.
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.
Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.
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:
- Lead with transparency We build trust by being open and listening intently in every interaction.
- Perform with integrity We choose the right path, even when it is hard.
- Chase excellence We set the bar high and measure our success. What gets measured gets done.
- Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
- Win together Our greatest victories come when our clients succeed.
We don’t just work together—we grow together. If that sounds like your kind of workplace, we’d love to meet you.
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