Remote/Hybrid WC Claims Expert | Growth & ESOP

CCMSI; Nashville (TN); Hybrid; USD 60,000 - 85,000; Full time

Benefits offered by this job

Paid time off

Paid holidays

Medical, Dental, Vision insurance

401(k) with ESOP

Career growth opportunities

Job summary

CCMSI is seeking a Workers' Compensation Claim Adjuster in Nashville, TN with hybrid or remote options. You will manage a workload of 100–125 claims across multiple jurisdictions, ensuring compliance with state regulations and client requirements.

The role emphasizes independent caseload management, effective communication with injured workers, and delivering quality outcomes. The position offers hybrid/remote work with strong career growth and comprehensive benefits.

Qualifications

• 5+ years of Workers' Compensation claims handling experience preferred.
• Active Georgia Workers' Compensation Adjuster License required (or ability to obtain if applicable).
• Experience managing claims from investigation through resolution.
• Experience handling indemnity claims.
• Strong written and verbal communication skills.
• Experience establishing reserves and evaluating claim exposure.
• Ability to independently manage a caseload of 85–125 claims.
• Experience handling litigated claims.
• Proficiency with Microsoft Office applications including Outlook, Word, and Excel.

Responsibilities

• Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
• Establish reserves and/or provide reserve recommendations within established reserve authority levels.
• Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
• Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
• Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
• Assess and monitor subrogation claims for resolution.
• Review and maintain personal diary on claim system.
• Client satisfaction.
• Prepare reports detailing claim status, payments and reserves, as requested.
• Compute disability rates in accordance with state laws.
• Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
• Prepare newsletter articles, as requested.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Handle more complex and involved claims than lower level claim positions with minimum supervision.
• Conduct claim reviews and/or training sessions for designated clients, as requested.
• Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

Skills

Caseload management

Negotiation

Communication

Microsoft Office

Tools

Microsoft Office

Job description

CCMSI is seeking a Workers' Compensation Claim Adjuster in Nashville, TN with hybrid or remote options. You will manage a workload of 100–125 claims across multiple jurisdictions, ensuring compliance with state regulations and client requirements.

The role emphasizes independent caseload management, effective communication with injured workers, and delivering quality outcomes. The position offers hybrid/remote work with strong career growth and comprehensive benefits.