Senior California WC Claims Consultant (Remote)

CCMSI; Irvine (CA); Remote; USD 80,000 - 98,000; Full time

Benefits offered by this job

4 weeks paid time off

10 paid holidays

Medical, Dental, Vision, Life, and Dis

401(k) and ESOP

Job summary

CCMSI in California seeks a Senior Workers’ Compensation Claim Consultant to manage a complex portfolio with confidence and sound judgment. With 5+ years of hands-on claims experience, you will lead investigations, guide strategy, and deliver timely resolutions in a remote setting.

This role offers a strong development path into more senior positions and emphasizes quality, compliance, and client service across a national client base.

Qualifications

• Five (5) or more years of California Workers’ Compensation claims experience, managing full life-cycle claims.
• Demonstrated experience handling complex indemnity claims with minimal supervision.
• Hands-on experience calculating California AWW, including stipends or non-traditional wage components.
• Strong understanding of California Labor Code and WC regulations related to wage determination and benefits.
• Ability to independently evaluate and defend wage determinations when disputed.

Responsibilities

• Investigate, evaluate, and adjust claims in compliance with company standards and laws.
• Establish and manage reserves within authority guidelines.
• Review, approve, and negotiate medical, legal, and related claim expenses.
• Authorize claim payments and negotiate settlements within guidelines.
• Coordinate external vendors and monitor claim progression and reporting.

Skills

California WC claims

Claim investigation

Negotiation

Reserving

MS Office

Education

Bachelor's degree preferred

Tools

Microsoft Office

Job description

CCMSI in California seeks a Senior Workers’ Compensation Claim Consultant to manage a complex portfolio with confidence and sound judgment. With 5+ years of hands-on claims experience, you will lead investigations, guide strategy, and deliver timely resolutions in a remote setting.

This role offers a strong development path into more senior positions and emphasizes quality, compliance, and client service across a national client base.