Remote Workers' Compensation Claims Adjuster – CA Jurisdiction

Overview:

Position Title: Workers’ Compensation Claim Consultant
Location: Remote
Hours: Monday - Friday, 8:00 AM to 4:30 PM
Salary Range: $70,000 - $95,000

Disclaimer: "The posted salary range for this position reflects the anticipated base pay for this role. Actual pay is determined based on factors such as qualifications, skills, relevant experience, internal equity, and location. Additional compensation may include discretionary bonuses, benefits, or other forms of compensation, depending on the role. The salary range provided is in compliance with state and local requirements and is intended to offer transparency to applicants. We encourage open discussions with our hiring team regarding any questions you may have about compensation and benefits for this position."

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

About CCMSI:

At CCMSI, we seek the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we’re united by a common mission to deliver exceptional service to our clients. As an employee-owned company, we focus on developing our staff through structured career development programs and by rewarding individual and team efforts. Certified as a Great Place to Work, CCMSI’s employee satisfaction and retention rank in the 95th percentile, reflecting our commitment to an outstanding work environment.

Why Join CCMSI?

• Culture: Our Core Values shape how we treat employees as valued partners—with integrity, passion, and enthusiasm.
• Career Development: CCMSI offers robust internships and internal training programs to support growth and advancement within the organization.
• Comprehensive Benefits: Enjoy 4 weeks of paid time off in your first year, 10 paid holidays, and a benefits package that includes Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and Employee Stock Ownership Program (ESOP).
• Supportive Work Environment: We believe in creating a workplace where employees enjoy coming to work each day, are provided with the resources to succeed, and manage realistic caseloads.

Position Summary:

The Workers’ Compensation Claim Consultant will oversee a multiple-account desk within the California jurisdiction, investigating and adjusting assigned Workers' Compensation claims to ensure high-quality service. This role requires a CA Self-Insurance Plan (SIP) or experienced adjuster certificate and at least 5 years of California Workers' Compensation claim handling experience. Bilingual proficiency in Spanish is highly desired. This position also provides an excellent opportunity for growth, potentially serving as a training ground for more senior claims roles.

• Investigate, evaluate, and adjust Workers' Compensation claims in line with California standards and laws.
• Determine compensability, calculate wages, and issue timely Temporary Disability (TD) payments.
• Manage litigation and communicate effectively with all parties involved.
• Establish and maintain reserves within authority levels.
• Approve medical, legal, and miscellaneous invoices, negotiating disputes when needed.
• Ensure compliance with claims best practices, including timely compensability decisions, diary maintenance, indemnity payments, and medical bill processing.
• Negotiate settlements within corporate and client standards, adhering to state laws.
• Work with external vendors, including legal and case management services, as appropriate.
• Maintain a personal diary for tracking claims and prepare status reports as needed.
• Calculate disability rates and coordinate communication with clients and claimants.
• Attend hearings, mediations, and legal conferences as required.
• Notify excess/reinsurance carriers of qualifying claims.
• Perform additional duties as assigned.

Performance Metrics:

• • Timely compensability decision-making
  • Accurate and prompt indemnity payments
  • Effective diary management and medical bill processing
  • Adherence to best practices in claim handling

• Experience: Minimum of 5 years of California Workers' Compensation claim handling experience. Bachelor’s degree preferred.
• Certification: CA SIP or experienced adjuster certificate required.
• Skills: Strong analytical, communication, and negotiation skills; detail-oriented, self-motivated, and capable of managing pressures in a dynamic environment.
• Computer Skills: Proficient in Microsoft Office.
• Language: Bilingual (Spanish) highly desired.

Working Conditions:

• Physical Demands: Light lifting, extended periods of sitting or standing, and sufficient auditory and visual acuity for interaction.

Core Values & Principles:

Employees are expected to uphold CCMSI’s Core Values and Principles,

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.

Apply today to join a dynamic team focused on professional growth and delivering exceptional service! #CCMSILasVegas #WorkersCompensation #ClaimsConsultant #HiringNow #RemoteJobs #CCMSICareers #InsuranceJobs #BilingualJobs #EmployeeOwned #CareerGrowth #CaliforniaJobs #JoinOurTeam #GreatPlaceToWork #CAWorkComp #IND123