CCMSI
Overview
Workers' Compensation Medical Only Claim Representative
Location:
Irvine, CA (Hybrid after initial training period) Schedule:
Monday-Friday, 8:00 AM-4:30 PM PST (37.5 hour work week) Pay Range:
$23.00-$25.00 per hour (dependent on experience)
Build Your Career With Purpose at CCMSI
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 Medical Only Claim Representative
to support a
PEO/Staffing account
handling
California medical-only workers' compensation claims . This role is
in-office during initial training , with a
hybrid schedule available afterward , reporting to our
Irvine, CA branch .
This position is ideal for a claims professional with an interest in workers' compensation who enjoys medical management, organization, and accuracy. You'll manage medical-only claims from setup through closure while partnering closely with adjusters and client teams. This role may also serve as a
training ground for advancement
into intermediate or full adjusting positions.
Responsibilities
When we hire claims professionals at CCMSI, we look for people who understand that every claim represents a real person's livelihood, take ownership of their work, and approach each task with care, accuracy, and accountability. Set up and manage
medical-only workers' compensation claim files
in compliance with California law and CCMSI standards Establish reserves and provide reserve recommendations within assigned authority levels under supervision Review and approve medical and related invoices to ensure accuracy, reasonableness, and claim-relatedness Assist with negotiation and resolution of disputed medical bills under guidance Request, track, and monitor medical treatment in accordance with corporate standards and client instructions Accurately summarize medical records and correspondence within the claim system Maintain timely diary management and documentation Close medical-only claims when appropriate and in compliance with guidelines Provide administrative and claim support to adjusters and client service teams Ensure ongoing compliance with Corporate Claim Handling Standards and client-specific requirements Qualifications
Required
Associate degree
or
two years of related business, insurance, medical, or administrative experience Strong organizational skills with the ability to manage multiple tasks and priorities Clear written and verbal communication skills Ability to work independently while collaborating within a team environment Reliable, predictable attendance within established client service hours Preferred SIP designation
or interest in obtaining Knowledge of medical terminology Prior experience supporting workers' compensation or medical claims 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
At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:
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 This is where we shine, and we hire adjusters who want to shine with us.
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
At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who:
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.
We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.
#NowHiring #WorkersCompensation #MedicalOnlyClaims #WCClaims #ClaimsCareers #CaliforniaWorkersComp #CAClaims #InsuranceCareers #TPACareers #PEOClaims #StaffingClaims #HybridWork #IrvineCAJobs #EmployeeOwned #GreatPlaceToWorkCertified #CareerWithPurpose #CCMSICareers #LI-Hybrid
Workers' Compensation Medical Only Claim Representative
Location:
Irvine, CA (Hybrid after initial training period) Schedule:
Monday-Friday, 8:00 AM-4:30 PM PST (37.5 hour work week) Pay Range:
$23.00-$25.00 per hour (dependent on experience)
Build Your Career With Purpose at CCMSI
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 Medical Only Claim Representative
to support a
PEO/Staffing account
handling
California medical-only workers' compensation claims . This role is
in-office during initial training , with a
hybrid schedule available afterward , reporting to our
Irvine, CA branch .
This position is ideal for a claims professional with an interest in workers' compensation who enjoys medical management, organization, and accuracy. You'll manage medical-only claims from setup through closure while partnering closely with adjusters and client teams. This role may also serve as a
training ground for advancement
into intermediate or full adjusting positions.
Responsibilities
When we hire claims professionals at CCMSI, we look for people who understand that every claim represents a real person's livelihood, take ownership of their work, and approach each task with care, accuracy, and accountability. Set up and manage
medical-only workers' compensation claim files
in compliance with California law and CCMSI standards Establish reserves and provide reserve recommendations within assigned authority levels under supervision Review and approve medical and related invoices to ensure accuracy, reasonableness, and claim-relatedness Assist with negotiation and resolution of disputed medical bills under guidance Request, track, and monitor medical treatment in accordance with corporate standards and client instructions Accurately summarize medical records and correspondence within the claim system Maintain timely diary management and documentation Close medical-only claims when appropriate and in compliance with guidelines Provide administrative and claim support to adjusters and client service teams Ensure ongoing compliance with Corporate Claim Handling Standards and client-specific requirements Qualifications
Required
Associate degree
or
two years of related business, insurance, medical, or administrative experience Strong organizational skills with the ability to manage multiple tasks and priorities Clear written and verbal communication skills Ability to work independently while collaborating within a team environment Reliable, predictable attendance within established client service hours Preferred SIP designation
or interest in obtaining Knowledge of medical terminology Prior experience supporting workers' compensation or medical claims 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
At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:
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 This is where we shine, and we hire adjusters who want to shine with us.
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
At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who:
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.
We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.
#NowHiring #WorkersCompensation #MedicalOnlyClaims #WCClaims #ClaimsCareers #CaliforniaWorkersComp #CAClaims #InsuranceCareers #TPACareers #PEOClaims #StaffingClaims #HybridWork #IrvineCAJobs #EmployeeOwned #GreatPlaceToWorkCertified #CareerWithPurpose #CCMSICareers #LI-Hybrid