New Mexico Work Comp Insurance Adjuster

CCMSI; Albuquerque (NM); Hybrid; USD 55,000 - 65,000; Full time

Benefits offered by this job

4 weeks PTO + 10 paid holidays in your

Medical, Dental, Vision, Life, and Dis

401(k) and ESOP

Career growth opportunities

Team-based culture

Job summary

CCMSI in Albuquerque, NM is hiring a Workers' Compensation Claim Representative I. The role covers investigation, administration, and adjustment of claims across multiple client accounts within New Mexico.

The position supports cradle‑to‑grave claim life cycles, including investigation, benefit administration, and settlement negotiations. A strong background in WC claims and collaboration with teams is essential.

Qualifications

• 3+ years of Workers’ Compensation claims experience or related insurance industry experience.
• Ability to prioritize and manage multiple tasks independently.
• Strong communication skills with internal teams, clients, and external partners.
• Confidentiality and accuracy in a fast‑paced environment.
• Reliable attendance during established hours.

Responsibilities

• Investigate and adjust workers compensation claims per CCMSI procedures.
• Review and negotiate medical and legal invoices for relatedness and reasonableness.
• Authorize and process payments within settlement authority.
• Negotiate settlements with claimants/attorneys.
• Assist in selecting and supervising defense attorneys.
• Monitor subrogation claims and resolutions.
• Prepare reports detailing claims, payments and reserves.
• Provide required reporting to excess insurers and clients.

Skills

Strong organizational skills

Effective verbal and written skills

Ability to work collaboratively in a动态

Reliable and predictable attendance

Proficiency with Microsoft Office

Education

Associate’s degree or higher

Active New Mexico Adjusters License

Tools

Microsoft Office

Job description

Overview

Workers' Compensation Claim Representative I

Location: Albuquerque, New Mexico

Schedule: Mon - Fri 8:00 am - 4:30 pm Hybrid schedule after initial training

Compensation: $55,000 - $65,000 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

The Workers' Compensation Claim Representative I is responsible for the investigation, administration, and adjustment of assigned workers' compensation claims. This position may be used as an advanced training role for future promotion to a Workers' Compensation Claim Representative II or other senior-level claims positions. Accountable for the quality of claim services as perceived by CCMSI clients and in accordance with corporate claim handling standards.

This role will manage claims across multiple client accounts within the New Mexico jurisdiction and is responsible for handling claims through the full claim life cycle, from initial report through closure ("cradle to grave"). The ideal candidate will have experience managing moderately complex workers' compensation claims, including investigation, compensability determination, benefit administration, reserve management, return-to-work coordination, and claim resolution.

Responsibilities

• 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.

Qualifications

What You’ll Bring

• 3+ years of Workers’ Compensation claims experience or related insurance industry experience.
• Strong organizational skills with the ability to prioritize and manage multiple tasks independently.
• Effective verbal and written communication skills for interaction with internal teams, clients, and external partners.
• Ability to work collaboratively in a fast-paced, changing environment while maintaining accuracy and confidentiality.
• Reliable and predictable attendance during established hours.
• Proficiency with Microsoft Office applications (Word, Excel, Outlook).
• Active New Mexico Adjusters License
• Experience supporting various industries of Workers’ Compensation claims.

Nice to Have

• Associate’s degree or higher, or related insurance indusstry experience.
• 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

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. If you need assistance or accommodation, please contact our team.

Equal Opportunity Employer

CCMSI is an Affluent 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.

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.

#CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #TPA #InsuranceCareers #NewMexicoJobs #AlbuquerqueJobs #CareerGrowth #ClaimsCareers #IND123