Remote CA Workers' Comp Claim Specialist

CCMSI; Las Vegas (NV); À distance; USD 88 000 - 92 000; Plein temps

Avantages offerts par ce poste

4 weeks PTO and 10 paid holidays

Comprehensive benefits (medical, etc.)

401(k) and ESOP

Career growth opportunities

Team-based culture

Résumé du poste

CCMSI is seeking a driven Workers' Compensation Claim Specialist to own a dedicated portfolio for a single PEO account, lead investigations, determine compensability, and guide cases toward timely resolution. This role builds client relationships and deep client operations knowledge within a dedicated-account structure.

Opportunity to grow technical expertise and pursue advanced development paths toward supervisory or management roles.

Qualifications

• 5+ years of California Workers’ Compensation claims handling experience, including full claim investigation, evaluation, and resolution.
• Must be able to travel one time a year.
• SIP and CA adjusters license is required.
• Experience handling litigated and lost time claims.
• Strong analytical and negotiation abilities.
• Knowledge of all lower‑level claim position responsibilities.

Responsabilités

• Investigate, evaluate and adjust claims in accordance with established claim handling standards and applicable laws.
• Establish reserves within assigned authority levels and provide notice of qualifying claims to excess or reinsurance carriers when appropriate.
• Review, approve and oversee medical, legal, damage estimates, invoices and other external vendor services to ensure they are reasonable, necessary and related to designated claims. Negotiate disputed bills and supervise referrals to outside vendors.
• Authorize and issue claim payments in accordance with claim procedures, industry standards and established authority levels.
• Negotiate settlements in accordance with Corporate Claim Standards, client-specific handling instructions and applicable laws.
• Review and maintain claim diaries within the claim management system.
• Assess and monitor subrogation opportunities through resolution.
• Compute disability rates in accordance with applicable state laws.
• Maintain effective and timely communication with clients, claimants and other stakeholders while ensuring compliance with Corporate Claim Handling Standards and client-specific handling instructions.

Connaissances

Analytical skills

Negotiation skills

Client communication

CA WC claims process knowledge

Formation

Bachelor's degree preferred

SIP license

CA adjuster license preferred

Professional designations (AIC/ARM/CPCU) preferred

Description du poste

CCMSI is seeking a driven Workers' Compensation Claim Specialist to own a dedicated portfolio for a single PEO account, lead investigations, determine compensability, and guide cases toward timely resolution. This role builds client relationships and deep client operations knowledge within a dedicated-account structure.

Opportunity to grow technical expertise and pursue advanced development paths toward supervisory or management roles.