Remote CA Workers' Comp Claims Specialist

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

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.