CCMSI
Workers’ Compensation Claim Rep II (CA Expertise Required)
CCMSI, California, Missouri, United States, 65018
Join to apply for the
Workers’ Compensation Claim Rep II (CA Expertise Required)
role at
CCMSI
Location: Hybrid or Remote – reporting to the Irvine, CA branch
Schedule: Monday–Friday, 8:00 AM–4:30 PM PST
Salary Range: $70,000–$80,000 annually (dependent on experience)
Overview At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don’t just process claims—we support people. As the largest privately‑owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work® and our employee‑owners are empowered to grow, collaborate, and make meaningful contributions every day.
Job Summary We are seeking a
Workers’ Compensation Claim Representative II
to manage
California workers’ compensation claims from intake through resolution
for a
PEO/Staffing account . This role may be remote or hybrid, reporting to our Irvine, CA branch. This position is designed for an experienced adjuster who can independently manage claims, apply sound judgment, and deliver consistent results within California’s complex regulatory environment. You’ll handle more complex claim scenarios, contribute to claim strategy, and partner closely with supervisors, clients, and vendors to drive quality outcomes.
Responsibilities
Independently investigate, evaluate, and resolve California workers’ compensation claims in compliance with CCMSI standards and client handling instructions
Manage claims cradle‑to‑grave, including compensability, medical management, litigation coordination, and resolution strategy
Review medical, legal, and miscellaneous invoices for accuracy, reasonableness, and claim‑relatedness; negotiate disputed bills
Establish, monitor, and adjust reserves in accordance with authority levels and best practices
Authorize and issue claim payments within assigned settlement authority
Negotiate settlements with injured workers and attorneys in accordance with client authorization
Coordinate with and assist in the selection and oversight of defense counsel
Identify and pursue subrogation opportunities
Prepare and maintain accurate claim documentation, reports, payments, and reserve summaries
Ensure compliance with service commitments, jurisdictional requirements, and excess reporting obligations
Deliver consistent, high‑quality claim service aligned with CCMSI’s corporate standards
Qualifications What You’ll Bring Required
5–10 years of workers’ compensation claims experience, with demonstrated success handling California claims
Proven ability to manage claims independently from intake through resolution
Strong working knowledge of the California workers’ compensation claims process
Excellent communication, organization, and time‑management skills
Ability to prioritize work, meet deadlines, and manage a full caseload with minimal supervision
Reliable, predictable attendance within established client service hours
Preferred
SIP designation or ability to obtain within a defined timeframe
Associate degree or higher
Experience supporting PEO and/or staffing accounts
Proficiency with Microsoft Word, Excel, Outlook, and claims systems
Bilingual (Spanish) proficiency—highly valued for communicating with claimants, employers, or vendors, but not required
Why You’ll Love Working Here
4 weeks PTO + 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.
#J-18808-Ljbffr
Workers’ Compensation Claim Rep II (CA Expertise Required)
role at
CCMSI
Location: Hybrid or Remote – reporting to the Irvine, CA branch
Schedule: Monday–Friday, 8:00 AM–4:30 PM PST
Salary Range: $70,000–$80,000 annually (dependent on experience)
Overview At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don’t just process claims—we support people. As the largest privately‑owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work® and our employee‑owners are empowered to grow, collaborate, and make meaningful contributions every day.
Job Summary We are seeking a
Workers’ Compensation Claim Representative II
to manage
California workers’ compensation claims from intake through resolution
for a
PEO/Staffing account . This role may be remote or hybrid, reporting to our Irvine, CA branch. This position is designed for an experienced adjuster who can independently manage claims, apply sound judgment, and deliver consistent results within California’s complex regulatory environment. You’ll handle more complex claim scenarios, contribute to claim strategy, and partner closely with supervisors, clients, and vendors to drive quality outcomes.
Responsibilities
Independently investigate, evaluate, and resolve California workers’ compensation claims in compliance with CCMSI standards and client handling instructions
Manage claims cradle‑to‑grave, including compensability, medical management, litigation coordination, and resolution strategy
Review medical, legal, and miscellaneous invoices for accuracy, reasonableness, and claim‑relatedness; negotiate disputed bills
Establish, monitor, and adjust reserves in accordance with authority levels and best practices
Authorize and issue claim payments within assigned settlement authority
Negotiate settlements with injured workers and attorneys in accordance with client authorization
Coordinate with and assist in the selection and oversight of defense counsel
Identify and pursue subrogation opportunities
Prepare and maintain accurate claim documentation, reports, payments, and reserve summaries
Ensure compliance with service commitments, jurisdictional requirements, and excess reporting obligations
Deliver consistent, high‑quality claim service aligned with CCMSI’s corporate standards
Qualifications What You’ll Bring Required
5–10 years of workers’ compensation claims experience, with demonstrated success handling California claims
Proven ability to manage claims independently from intake through resolution
Strong working knowledge of the California workers’ compensation claims process
Excellent communication, organization, and time‑management skills
Ability to prioritize work, meet deadlines, and manage a full caseload with minimal supervision
Reliable, predictable attendance within established client service hours
Preferred
SIP designation or ability to obtain within a defined timeframe
Associate degree or higher
Experience supporting PEO and/or staffing accounts
Proficiency with Microsoft Word, Excel, Outlook, and claims systems
Bilingual (Spanish) proficiency—highly valued for communicating with claimants, employers, or vendors, but not required
Why You’ll Love Working Here
4 weeks PTO + 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.
#J-18808-Ljbffr