JOB DETAILS

Workers' Compensation Claim Adjuster - Texas - Remote or Hybrid

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.

We are seeking an experienced Workers' Compensation Claim Consultant to join our team. This position offers flexibility with hybrid or remote work arrangements, depending on your location. The ideal candidate must have a strong background in handling Texas workers' compensation claims, with specific experience in managing claims for school districts and/or public entities. A deep understanding of the unique challenges and nuances associated with these types of claims is essential.

As a Workers' Compensation Claim Consultant, you will be responsible for investigating and adjusting assigned claims while maintaining the high standards of service our clients expect. This role also serves as an advanced training opportunity, potentially leading to a promotion to a more senior-level position. The work schedule is Monday through Friday, 8 am to 4:30 pm.

If you are detail-oriented, possess strong analytical skills, and have a passion for delivering exceptional claim services, we encourage you to apply. Join us in providing top-tier service to our valued clients within the school district and public entity sectors.

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 Adjusters license is required

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 #CCMSITexas #EmployeeOwned #ESOP #GreatPlaceToWork #WorkersCompensation #ClaimsAdjuster #PublicEntityClaims #SchoolDistrictClaims #RiskManagement #ClaimsConsultant #InsuranceCareers #WorkersComp #TexasClaims #PublicSector #ClaimsHandling #LegalCompliance #ReturnToWork #InsuranceJobs #WorkplaceSafety #TexasWorkComp #IND123

Related Jobs

Workers' Compensation Claim Supervisor - Texas Claims - Remote or Hybrid

CCMSI • Dallas, TX, US • 4w ago

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 ex... more

4w ago

Apply

Controller

Venturity • Full-time • Dallas • 16m 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

16m ago

Apply

Assistant Controller

Venturity • Full-time • Dallas • 16m 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

16m ago

Apply

Grocery Floor Clerk

WinCo Foods • Garland, TX, US • 1d ago

Retail

About Us Join us at WinCo Foods, where we're more than just a grocery retailer - we're a growing family of over 140 supermarkets in 10 states with over 22,000 employee owners. Our purpose is to make the lives our cust... more

1d ago

Apply

Site Manager | Dallas, TX

Davey Tree • Dallas, TX, US • 1d ago

Additional Locations: United States (main location will be Dallas with opportunity for travel throughout the US) Primary Locations: TX, Dallas, 1999 Bryan Street, Suite 900, 75201 Requisition ID: 2021... more

1d ago

Apply

Part-Time Grocery Stocking/Reset Merchandising Representative in South Dallas, Tx.

P.L. Marketing • Part-time • Dallas, Texas, United States • 3d 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

3d ago

Apply

Branch Associate

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

Retail

Locke Supply Company of DeSoto, TX is seeking an outgoing and energetic Branch Associate to provide excellent customer service at our branch... more

4d ago

Apply

Climbing Arborist Crew Lead Trainee | Richardson, TX | Dallas Metro

Davey Tree • Richardson, TX, US • 4d ago

Agriculture & Forestry

Additional Locations: none Primary Locations: TX, Richardson, 880 North Dorothy Dr., Suite 814, 75081 Requisition ID: 201130 Position Overview Foreman Trainee assists in directing crew mem... more

4d ago

Apply

Meat Clerk

WinCo Foods • Garland, TX, US • 4d ago

Retail

4d ago

Apply

Janitorial Clerk

WinCo Foods • Garland, TX, US • 1w ago

Retail Janitorial

1w ago

Apply