[Hiring] Workers' Compensation Claim Specialist @Ccmsi

Role Description

We are seeking a driven and compassionate Workers’ Compensation Claim Specialist to join our team and make a meaningful impact in the lives of injured workers. In this role, you will take ownership of a dedicated portfolio of claims—leading investigations, determining compensability, and guiding each case toward a fair and timely resolution.

This position offers the opportunity to grow your technical expertise and can serve as an advanced development path for future supervisory or management roles. As a Claim Specialist, you play a vital role in delivering the high-quality service our clients count on and upholding CCMSI’s commitment to excellence.

Responsibilities

• Manage workers' compensation claims from investigation through resolution in compliance with company standards and applicable laws.
• Evaluate claim exposure and establish appropriate reserves within authority guidelines.
• Review and approve medical, legal, and other claim-related expenses to ensure accuracy and cost effectiveness.
• Issue claim payments and negotiate settlements in accordance with company, client, and state requirements.
• Coordinate with attorneys, medical providers, case managers, and other vendors to support effective claim outcomes.
• Monitor claim activity, maintain accurate file documentation, and manage diary schedules.
• Identify and pursue subrogation opportunities and excess/reinsurance reporting requirements.
• Calculate disability benefits and ensure timely, accurate claim administration.
• Maintain proactive communication with clients, claimants, and other stakeholders throughout the claim lifecycle.
• Adhere to corporate claim handling standards and client-specific service instructions.

Qualifications

• 5+ years of Workers’ Compensation claims handling experience, including full claim investigation, evaluation, and resolution.
• Responsiveness to internal and external client needs.
• Strong analytical and negotiation abilities.
• Knowledge of all lower-level claim position responsibilities.
• Adjuster’s license may be required based on jurisdiction.
• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
• Bachelor's degree is preferred but not required.
• Professional designations such as AIC, ARM, or CPCU are preferred but not required.

Benefits

• 4 weeks of 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.
• A supportive, team-based work environment.

How We Measure Success

• 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.

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.

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.

Our Core Values

• 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.