Workers’ Compensation Claim Specialist
About the position 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. The Workers’ Compensation Claim Specialist is responsible for the investigation, evaluation, and adjustment of California workers’ compensation claims for a single dedicated transportation industry client. This role ensures compliance with California jurisdictional requirements while maintaining CCMSI’s commitment to timely, accurate, and client-focused service. This position offers the opportunity to work remotely, collaborate closely with a supportive team, and contribute to a high-performing, employee-owned organization that values both excellence and balance.
Responsibilities
- Investigate, evaluate, and adjust workers’ compensation claims in accordance with California laws, CCMSI standards, and client handling requirements.
- Establish and maintain appropriate reserves within assigned authority levels.
- Review and authorize payments for medical, legal, and indemnity expenses, ensuring accuracy and compliance.
- Negotiate settlements consistent with client expectations, corporate standards, and state regulations.
- Maintain accurate claim documentation and timely diary management within the claim system.
- Communicate effectively with clients, claimants, medical providers, and other stakeholders throughout the claim lifecycle.
- Participate in claim reviews and internal audits as part of ongoing quality and compliance initiatives.
- Support client relationships by delivering high-quality, timely, and compliant claim handling.
Requirements
- Minimum of 10 years of workers’ compensation claim adjusting experience.
- Proficiency in Microsoft Office (Word, Excel, Outlook).
- Strong written and verbal communication skills.
- Proven ability to manage deadlines and multiple priorities effectively.
- California jurisdiction experience required.
Nice-to-haves
- Billingual (Spanish) proficiency- highly valued for communication with claimaints, employers, or vendors, but not required.
- California SIP certification.
- Claim review presentation experience.
- AIC, ARM, or CPCU designation.
Benefits
- 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
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