CA Work Comp Insurance Adjuster

CCMSI; Irvine (CA); Hybrid; USD 85,000 - 95,000; Full time

Benefits offered by this job

4 weeks PTO + 10 holidays

Benefits package including medical/dac

401(k) and ESOP

Career growth & training

Team-oriented culture

Job summary

CCMSI in Irvine, CA is seeking a Workers’ Compensation Claim Specialist. You will own a portfolio of claims, guide investigations, determine compensability, and drive timely resolutions. This position offers growth paths into supervisory or management levels and requires balancing empathy with sound judgment.

You will work to ensure compliance, accurate reserves, and effective collaboration with clients, attorneys, and medical providers while upholding CCMSI’s service standards and values.

Qualifications

• 5+ years of Workers’ Compensation claims handling experience.
• Adjuster license may be required depending on jurisdiction.
• Spanish bilingualism is valued but not required.
• Bachelor's degree preferred, professional designations encouraged.

Responsibilities

• Manage workers' compensation claims from investigation through resolution.
• Evaluate claim exposure and establish reserves within authority guidelines.
• Review and approve medical, legal, and other claim-related expenses for accuracy and cost effectiveness.
• Issue claim payments and negotiate settlements in accordance with requirements.
• Coordinate with attorneys, medical providers, case managers, and other vendors.
• Maintain accurate file documentation and diary schedules.
• Identify and pursue subrogation opportunities and reporting requirements.
• Maintain proactive communication with clients, claimants, and stakeholders.

Skills

Claims handling

Analytical abilities

Negotiation

Adjuster license

Spanish bilingual

Claims knowledge

Education

Bachelor's degree preferred

AIC/ARM/CPCU certifications preferred

Job description

Workers' Compensation Claim Specialist

Overview

Workers' Compensation Claim Specialist

Location: Irvine, CA (reporting remotely)

Schedule: Mon- Fri 8:00 am - 4:30 pm (PST)

Salary Range: $85,000 - $95,000 (depending 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 driven and compassionate Workers’ Compensation Claim Specialist 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 claims—leading investigations, determining compensability, and guiding each case toward a fair and timely resolution.

This position offers the opportunity to grow your technical expertise and can serve 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

When we hire Workers’ Compensation Adjusters at CCMSI, we look for detail‑driven problem‑solvers who balance empathy with sound judgement, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust.

• Manage workers' compensation claims from investigation through resolution in compliance with company standards and applicable laws.
• Evaluate claim exposure and establish appropriate reserves within authority guidelines.
• Review and approve medical, legal, and other claim-related expenses to ensure accuracy and cost effectiveness.
• Issue claim payments and negotiate settlements in accordance with company, client, and state requirements.
• Coordinate with attorneys, medical providers, case managers, and other vendors to support effective claim outcomes.
• Monitor claim activity, maintain accurate file documentation, and manage diary schedules.
• Identify and pursue subrogation opportunities and excess/reinsurance reporting requirements.
• Calculate disability benefits and ensure timely, accurate claim administration.
• Maintain proactive communication with clients, claimants, and other stakeholders throughout the claim lifecycle.
• Adhere to corporate claim handling standards and client-specific service instructions.

Qualifications

Required:

• 5+ years of Workers’ Compensation claims handling experience, including full claim investigation, evaluation, and resolution.
• Responsiveness to internal and external client needs.
• Strong analytical and negotiation abilities.
• Knowledge of all lower‑level claim position responsibilities.
• Adjuster’s license may be required based on jurisdiction.

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

Why You’ll Love Working Here

• 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

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 standardsTimeliness & 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.

CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.

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.

Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.

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.