[Hiring] Workers' Compensation Claim Specialist @CCMSI

Role Description

We are seeking an experienced Oklahoma Workers’ Compensation Claim Specialist to investigate, evaluate, and manage workers’ compensation claims while delivering outstanding service to our clients. In this role, you will make informed claim decisions, maintain compliance with industry and company standards, and contribute to positive claim outcomes. This position also provides opportunities for career advancement into leadership roles.

• 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.).
• Review and maintain personal diary on claim system.
• Assess and monitor subrogation claims for resolution.
• Compute disability rates in accordance with state laws.
• Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

Qualifications

• 5+ years of Oklahoma Workers’ Compensation claims handling experience, including full claim investigation, evaluation, and resolution.
• Experience handling multiple and various accounts.
• Responsiveness to internal and external client needs.
• Strong analytical and negotiation abilities.
• Oklahoma Adjuster's license.
• Knowledge of all lower-level claim position responsibilities.
• Past experience handling complex and litigate caseloads.

Requirements

• 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 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.