Workers' Compensation Claim Representative I

 

 

The Workers’ Compensation Claim Representative I handles the investigation and adjustment of assigned claims while ensuring high-quality service that meets CCMSI client expectations and company standards. This role also serves as a developmental position, preparing employees for advancement to higher-level claims roles. Experience handling education or educational services is preferred. 

 

 

When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person’s livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems.

• →Investigate and adjust workers compensation claims in accordance with established claims handling procedures using CCMSI guidelines and direct supervision. 
• →Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing workers compensation claims. Negotiate any disputed bills for resolution. 
• →Authorize and make payment of workers compensation claims utilizing a claim payment program in accordance with industry standards and within settlement authority. 
• →Negotiate settlements with claimants and attorneys in accordance with client's authorization. 
• →Assist in selection and supervision of defense attorneys. 
• →Assess and monitor subrogation claims for resolution. 
• →Prepare reports detailing claims, payments and reserves. 
• →Provide reports and monitor files, as required by excess insurers. 
• →Compliance with Service Commitments as established by team. 
• →Delivery of quality claim service to clients.

 

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 

 

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. 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.

 

 

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.

 

 

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