CCMSI
Workers' Compensation Claim Adjuster (DE, DC, MD)
CCMSI, Wall Township, New Jersey, United States
Workers' Compensation Claim Adjuster (DE, DC, MD)
Location:
Hybrid (Reporting to Wall Township, NJ)
Schedule:
Monday – Friday | 8:00 AM – 4:30 PM EST
Salary Range:
$65,000 – $70,000
Overview As a leading Third‑Party Administrator in self‑insurance services,
CCMSI
seeks the best and brightest talent to join our team of professionals. We are an employee‑owned company focused on structured career development, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile.
Reasons You Should Consider a Career With CCMSI
Culture: Our Core Values are embedded into our culture of treating employees as valued partners, with integrity, passion and enthusiasm.
Career development: CCMSI offers robust internships and internal training programs for advancement within our organization.
Benefits: Four weeks paid time off in the first year, ten paid holidays, medical, dental, vision, life insurance, critical illness, short and long‑term disability, 401(k) and ESOP.
Work environment: Employees enjoy coming to work each day, have the resources needed to perform their job and claims staff are assigned manageable caseloads.
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 reasonableness and relevance to designated claims; negotiate any disputed bills or invoices for resolution.
Authorize and make payments of claims in accordance with claim procedures using a claim payment program and within established payment authority.
Negotiate settlements in accordance with Corporate Claim Standards, client‑specific instructions and state laws, when appropriate.
Assist in the selection, referral and supervision of designated claim files sent to outside vendors (e.g., legal, surveillance, case management).
Assess and monitor subrogation claims for resolution.
Review and maintain personal diary on claim system.
Client satisfaction.
Prepare reports detailing claim status, payments and reserves as requested.
Compute disability rates in accordance with state laws.
Effectively and timely coordinate communication with clients, claimants and relevant parties throughout the claim adjustment process.
Prepare newsletter articles, as requested.
Provide notices of qualifying claims to excess/reinsurance carriers.
Handle more complex and involved claims than lower‑level positions with minimum supervision.
Conduct claim reviews and/or training sessions for designated clients, as requested.
Attend and participate in hearings, mediations and informal legal conferences, as appropriate.
Comply with Corporate Claim Handling Standards and special client handling instructions as established.
Perform other duties as assigned.
Qualifications Education and/or Experience:
Five or more years of claims experience required; bachelor’s degree preferred.
Computer Skills:
Proficient using Microsoft Office products such as Word, Excel and Outlook.
Certificates, Licenses, Registrations:
Adjuster’s license may be required based upon jurisdiction.
Physical Demands
Work requires the ability to stoop, bend, reach and grab with arms and hands, manual dexterity.
Work requires the ability to sit or stand up to 7.5 or more hours at a time.
Work requires sufficient auditory and visual acuity to interact with others.
Core Values & Principles Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focusing 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 initiative to make things better; and leading by example.
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. CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits.
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. If you need assistance or accommodation, please contact our team.
Equal Opportunity Employer CCMSI is an affirmative action / equal employment opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Human Resources
Industry Insurance
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Hybrid (Reporting to Wall Township, NJ)
Schedule:
Monday – Friday | 8:00 AM – 4:30 PM EST
Salary Range:
$65,000 – $70,000
Overview As a leading Third‑Party Administrator in self‑insurance services,
CCMSI
seeks the best and brightest talent to join our team of professionals. We are an employee‑owned company focused on structured career development, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile.
Reasons You Should Consider a Career With CCMSI
Culture: Our Core Values are embedded into our culture of treating employees as valued partners, with integrity, passion and enthusiasm.
Career development: CCMSI offers robust internships and internal training programs for advancement within our organization.
Benefits: Four weeks paid time off in the first year, ten paid holidays, medical, dental, vision, life insurance, critical illness, short and long‑term disability, 401(k) and ESOP.
Work environment: Employees enjoy coming to work each day, have the resources needed to perform their job and claims staff are assigned manageable caseloads.
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 reasonableness and relevance to designated claims; negotiate any disputed bills or invoices for resolution.
Authorize and make payments of claims in accordance with claim procedures using a claim payment program and within established payment authority.
Negotiate settlements in accordance with Corporate Claim Standards, client‑specific instructions and state laws, when appropriate.
Assist in the selection, referral and supervision of designated claim files sent to outside vendors (e.g., legal, surveillance, case management).
Assess and monitor subrogation claims for resolution.
Review and maintain personal diary on claim system.
Client satisfaction.
Prepare reports detailing claim status, payments and reserves as requested.
Compute disability rates in accordance with state laws.
Effectively and timely coordinate communication with clients, claimants and relevant parties throughout the claim adjustment process.
Prepare newsletter articles, as requested.
Provide notices of qualifying claims to excess/reinsurance carriers.
Handle more complex and involved claims than lower‑level positions with minimum supervision.
Conduct claim reviews and/or training sessions for designated clients, as requested.
Attend and participate in hearings, mediations and informal legal conferences, as appropriate.
Comply with Corporate Claim Handling Standards and special client handling instructions as established.
Perform other duties as assigned.
Qualifications Education and/or Experience:
Five or more years of claims experience required; bachelor’s degree preferred.
Computer Skills:
Proficient using Microsoft Office products such as Word, Excel and Outlook.
Certificates, Licenses, Registrations:
Adjuster’s license may be required based upon jurisdiction.
Physical Demands
Work requires the ability to stoop, bend, reach and grab with arms and hands, manual dexterity.
Work requires the ability to sit or stand up to 7.5 or more hours at a time.
Work requires sufficient auditory and visual acuity to interact with others.
Core Values & Principles Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focusing 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 initiative to make things better; and leading by example.
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. CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits.
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. If you need assistance or accommodation, please contact our team.
Equal Opportunity Employer CCMSI is an affirmative action / equal employment opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Human Resources
Industry Insurance
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