[Hiring] Workers’ Compensation Insurance Adjuster @CCMSI

Role Description

We are seeking a driven and compassionate Workers’ Compensation Insurance Adjuster 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 moderate‑complexity claims within a single account, leading investigations, determining compensability, and guiding each case toward a fair and timely resolution. Approximately 85% of the claims in this role are litigated, requiring strong critical thinking, negotiation, and litigation management skills.

This position offers the opportunity to grow your technical expertise and serves 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

• 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 with 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

• 2-3 years of California Workers’ Compensation claims handling experience, including full claim investigation, evaluation, and resolution.
• Responsiveness to internal and external client needs.
• Excellent time management skills.
• Experience handling litigated claims.
• Strong analytical and negotiation abilities.
• Must be able to handle claims from inception through resolution.
• SIP is required or must be able to obtain.

Nice to Have

• 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.

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.