Overview

Workers' Compensation Claim SpecialistLocation: Irvine, CA (reporting remotely)Schedule: Mon- Fri 8:00 am - 4:30 pm (PST)Salary Range: $85,000 - $95,000 (depending on experience)

Job SummaryWe are seeking a driven and compassionate Workers Compensation Claim Specialist to join our team and make a meaningful impact in the lives of injured workers. In this role, you will take ownership of a dedicated portfolio of claimsleading investigations, determining compensability, and guiding each case toward a fair and timely resolution. This position offers the opportunity to grow your technical expertise and can serve as an advanced development path for future supervisory or management roles. As a Claim Specialist, you play a vital role in delivering the highquality service our clients count on and upholding CCMSIs commitment to excellence.

ResponsibilitiesWhen we hire Workers Compensation Adjusters at CCMSI, we look for detaildriven problemsolvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust.

• Manage workers' compensation claims from investigation through resolution in compliance with company standards and applicable laws.
• Evaluate claim exposure and establish appropriate reserves within authority guidelines.
• Review and approve medical, legal, and other claim-related expenses to ensure accuracy and cost effectiveness.
• Issue claim payments and negotiate settlements in accordance with company, client, and state requirements.
• Coordinate with attorneys, medical providers, case managers, and other vendors to support effective claim outcomes.
• Monitor claim activity, maintain accurate file documentation, and manage diary schedules.
• Identify and pursue subrogation opportunities and excess/reinsurance reporting requirements.
• Calculate disability benefits and ensure timely, accurate claim administration.
• Maintain proactive communication with clients, claimants, and other stakeholders throughout the claim lifecycle.
• Adhere to corporate claim handling standards and client-specific service instructions.

Qualifications

Required:

• 5+ years of Workers Compensation claims handling experience, including full claim investigation, evaluation, and resolution.
• Responsiveness to internal and external client needs.
• Strong analytical and negotiation abilities.
• Knowledge of all lowerlevel claim position responsibilities.
• Adjusters license may be required based on jurisdiction.

Nice to Have:

• Bilingual (Spanish) proficiency 6 highly valued for communicating with claimants, employers, or vendors, but not required.
• Bachelor's degree is preferred but not required
• Professional designations such as AIC, ARM, or CPCU are preferred but not required

Why Youl Love Working Here

• 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
• Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
• Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
• Career growth: Internal training and advancement opportunities
• Culture: A supportive, team-based work environment

How We Measure Success

At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:

• Quality claim handling 6 thorough investigations, strong documentation, well-supported decisions
• Compliance & audit performance 6 adherence to jurisdictional and client standards
• Timeliness & accuracy 6 purposeful file movement and dependable execution
• Client partnership 6 proactive communication and strong follow-through
• Professional judgment 6 owning outcomes and solving problems with integrity
• Cultural alignment 6 believing every claim represents a real person and acting accordingly

This is where we shine, and we hire adjusters who want to shine with us.

Compensation & Compliance

The posted salary reflects CCMSIs good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.

CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.