JOB DETAILS

Workers' Compensation Claim Adjuster (Hybrid) (TX Claims)

Overview

At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile.

Reasons you should consider a career with CCMSI:

- Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm.
- Career development: CCMSI offers robust internships and internal training programs for advancement within our organization.
- Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP.
- Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads.

The Workers' Compensation Claim Consultant is responsible for the investigation and adjustment of assigned claims. This position may be used as an advanced training position for consideration of promotion to a more senior level claim position. Accountable for the quality of claim services as perceived by CCMSI clients and within our corporate claim standards.

This is a hybrid or remote position, depending on the location of the ideal candidate. The incumbent will be assigned to a dedicated client account and will primarily handle Texas Workers' Compensation Claims. A minimum of 5 years of experience adjusting TX Work Comp Claims is required.

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.)
Assess and monitor subrogation claims for resolution.
Review and maintain personal diary on claim system.
Client satisfaction.
Prepare reports detailing claim status, payments and reserves, as requested.
Compute disability rates in accordance with state laws.
Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
Prepare newsletter articles, as requested.
Provide notices of qualifying claims to excess/reinsurance carriers.
Handle more complex and involved claims than lower level claim positions with minimum supervision.
Conduct claim reviews and/or training sessions for designated clients, as requested.
Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
Performs other duties as assigned.

Qualifications

Education and/or Experience

Five or more years claims experience is required.

Computer Skills

Proficient using MicroSoft Office products such as Word, Excel, Outlook, etc.

Certificates, Licenses, Registrations

TX Adjuster's license is required

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work requires the ability to sit or stand up to 7.5 or more hours at a time.
Work requires sufficient auditory and visual acuity to interact with others.

CORE VALUES & PRINCIPLES

Responsible for upholding the CCMSI Core Values & 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.

CCMSI is an Affirmative Action/Equal Employment Opportunity employer offering an excellent benefit package included Medical, Dental, Vision, Prescription Drug, Flexible Spending, Life, ESOP and 401K.

#CCMSICareers #WorkersCompensation #TXWorkComp #TXClaims #RemoteWork #HybridWork #ClaimManagement #CareerDevelopment #ClaimManagement #CCMSI #InsuranceCareers #InsuranceIndustry #RemoteJob #WorkLifeBalance #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #ServiceOriented #IND123

Related Jobs

Controller

Venturity • Full-time • Dallas • 12m ago

Finance & Accounting

Overview As a Controller with Venturity you will be both a strong individual contributor and team leader, and will be responsible for managing and performing the month-end close process for a group of our clients,... more

12m ago

Apply

Assistant Controller

Venturity • Full-time • Dallas • 12m ago

Finance & Accounting

Overview As an Assistant Controller, you will be responsible for managing and performing the month-end close process (Reconciliations, Financial Statement Preparation and Analysis, etc.) for a group of our clients... more

12m ago

Apply

Staff Accountant

Venturity • Full-time • Dallas • 12m ago

Finance & Accounting

Overview As a Staff Accountant, will get to be hands on with the full accounting cycle for a variety of clients in multiple industries and work with a team of experienced accountants who can train and guide you. Th... more

12m ago

Apply

Full-Time Grocery Stocking/Reset Merchandising Representative in Grand Prairie, Texas

P.L. Marketing • Full-time • Grand Prairie, Texas, United States • 16h ago

Retail Stocking

POSITION SUMMARY: To make a positive contribution and measurably impact grocery store sales by ensuring successful execution of KOMPASS schedules by completing section plan-o-gram work on a scheduled weekly basis i... more

16h ago

Apply

Part-Time Grocery Stocking/Reset Merchandising Representative in Garland, Texas

P.L. Marketing • Part-time • Garland, Texas, United States • 1d ago

Retail Stocking

POSITION SUMMARY: To complete section plan-o-gram work on a scheduled weekly basis in a grocery store environment. VIDEO JOB DESCRIPTION: ESSENTIAL JOB FUNCTIONS: Read and understand plan-o-gra... more

1d ago

Apply

Tree Care Crew Member | CDL Driver (CDL Required) | Richardson, TX | Dallas

Davey Tree • Richardson, TX, US • 2d ago

Transportation

Additional Locations: none Primary Locations: TX, Richardson, 880 North Dorothy Dr., Suite 814, 75081 Requisition ID: 196877 Position Overview Trim and remove trees, remove unwanted, disea... more

2d ago

Apply

Climbing Arborist | Dallas Metro | Richardson, Texas

Davey Tree • Richardson, TX, US • 2d ago

Agriculture & Forestry

Additional Locations: none Primary Locations: TX, Richardson, 880 North Dorothy Dr., Suite 814, 75081 Requisition ID: 196878 Position Overview Trim and remove trees, remove unwanted, disea... more

2d ago

Apply

Part-Time Grocery Stocking/Reset Merchandising Representative in Garland, Texas

P.L. Marketing • Part-time • Garland, TX, US • 2d ago

Retail Stocking

Position Summary To complete section plan-o-gram work on a scheduled weekly basis in a grocery store environment. Video Job Description ESSENTIAL JOB FUNCTIONS: Read and understand plan-o-grams Collect pla... more

2d ago

Apply

Project Engineer-Hydraulic Modeling

RJN Group • Full-time • Dallas, Texas, United States • 3d ago

Engineering

Interested in working for the industry leader? Interested in having a substantial stake in an employee owned firm? Looking to help your neighbors and impact your local community? RJN Group employees can answer yes to a... more

3d ago

Apply

Branch Associate

Locke Supply • Mesquite, TX • $15 / hour • 4d ago

Retail

The Right Fit We're looking for motivated individuals who have a passion for sales, customer service, and desire advancement opportunities. High Character is at... more

4d ago

Apply