Overview
Senior Workers' Compensation Claims Specialist
Location: Remote (Concord, CA)
Schedule: Monday- Friday 8:00 am - 4:30pm PST
Salary Range: $87,000 - $97,000
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
The
Senior Workers’ Compensation Claim Specialist is responsible for managing the investigation and resolution of assigned workers’ compensation claims. This role serves as an advanced development opportunity for individuals being considered for future supervisory or management positions. The Senior Specialist is also responsible for ensuring the delivery of high-quality claims services that meet CCMSI’s corporate standards and align with client expectations.
Please note: This is not an HR, administrative, consulting, or advisory support role. This is a true adjusting position. Candidates must have proven experience conducting full investigation, evaluation, negotiation, and resolution of workers’ compensation claims, with end-to-end file ownership and decision-making authority. Applicants without direct claims adjusting experience will not be considered.
Responsibilities
- Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
- Establish reserves and/or provide reserve recommendations within established reserve authority levels.
- Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution.
- Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
- Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
- Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
- Review and maintain personal diary on claim system.
- Assess and monitor subrogation claims for resolution.
- Compute disability rates in accordance with state laws.
- Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
- Provide notices of qualifying claims to excess/reinsurance carriers.
- Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
Qualifications
What You'll Bring
Required:
- Strong oral and written communication skills
- 15 years of works' compensation claim adjusting
- Effective analytical and negotiation skills
- Ability to set and achieve performance goals with initiative
- Effective analytical and negotiation skills
- Ability to manage multiple client accounts and competing priorities
- Comprehensive knowledge of lower-level claims role responsibilities
- Experience adjusting lost-time claims and managing litigated files
- Detail-oriented, self-motivated, and highly organized
- Ability to coordinate, prioritize, and work with minimal supervision
- Flexible, accurate, and proactive approach to work
- Commitment to discretion and confidentiality
- Reliable and predictable attendance during client service hours
- Responsive to internal and external client needs
- Ability to communicate clearly and professionally in verbal and written formats
- Proficiency in Microsoft Office (Word, Excel, Outlook)
- California jurisdiction experience required.
Nice to Have:
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required
Preferred:
- California SIP certification
- Claim review presentation experience.
- AIC, ARM, or CPCU designation.
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
Why You’ll Love Working Here
- 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
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.
CCMSI posts internal career opportunities in compliance with applicable state and local promotion transparency laws.
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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