Experienced WC Claim Adjuster – California ADR Program (CA | Remote | SIP Required) at CCMSI
CCMSI · Irvine, United States Of America · Remote
- Professional
Workers’ Compensation Claim Consultant
Location: Remote – Reporting to California Jurisdiction
Schedule: Monday–Friday, 8:00 AM–4:30 PM PT
Salary Range: $80,000–$85,000 annually
Build Your Career With Purpose at CCMSI
At CCMSI, we don’t just process claims—we support people. As a leading Third Party Administrator and a certified Great Place to Work®, we offer manageable caseloads, employee ownership, and a collaborative culture. Our employee-owners are empowered to grow, contribute, and make a meaningful impact.
Job Summary
The Workers’ Compensation Claim Consultant is responsible for handling California workers’ compensation claims for a single dedicated Alternate Dispute Resolution (ADR) client account. This role requires California jurisdiction experience and an active CA Adjuster’s License, along with the Self-Insurance Administrator Certificate (SIP). You’ll join a team of 10 adjusters and play a key role in ensuring quality claim handling through compliance with client guidelines, state laws, and CCMSI claim standards.
Performance is measured by accuracy, timeliness, and client satisfaction, with a focus on no penalties, current diary management, complete documentation, and timely payments.
Responsibilities:Investigate, evaluate, and adjust assigned California workers’ compensation claims in compliance with jurisdictional requirements and ADR processes.
Establish and monitor reserves, authorize claim payments, and negotiate settlements within authority and client guidelines.
Review medical, legal, and vendor invoices to confirm accuracy and appropriateness.
Maintain thorough documentation and diary updates in the claim system.
Communicate effectively with clients, claimants, and involved parties throughout the claim process.
Participate in claim reviews, hearings, and mediations as needed.
Ensure compliance with state laws, CCMSI claim handling standards, and client-specific requirements.
Required
Three or more years of experience adjusting California workers’ compensation claims
California Adjuster’s License
Self-Insurance Administrator Certificate (SIP)
Strong written and verbal communication skills
Proficiency with Microsoft Office Suite (Word, Excel, Outlook)
Nice to Have
Experience with Alternate Dispute Resolution (ADR) claims
Strong organization, multitasking, and customer service skills
What We Offer
Employee Stock Ownership Plan (ESOP): We’re employee-owned, so your success is our success.
Comprehensive Benefits Package: Includes medical, dental, vision, life insurance, disability, and 401(k).
Generous Time Off: 4 weeks of paid time off in your first year, plus 10 paid holidays.
Career Growth: Structured training, career progression pathways, and opportunities to advance within CCMSI.
Supportive Environment: Manageable caseloads and a collaborative, team-focused culture.
Compensation & Compliance
The posted hourly rate 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.
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 Affirmative 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, our Core Values guide how we work: integrity, client service, employee ownership, continuous improvement, collaboration, and enthusiasm for what we do.
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