OverviewWorkers' Compensation Claim ConsultantLocation: Irvine, CA - must be able to attend training in office, then attend annual client meeting. Schedule: Mon-Fri 8:00 am - 4:30 pm Salary Range: $70,500 - $90,500 depending on experience.
Job SummaryWe are seeking an experienced and highly skilled
Workers’ Compensation Claim Consultant to manage a
dedicated client portfolio of complex California workers’ compensation claims with confidence, empathy, and sound professional judgment. With 5+ years of hands-on claims experience, you will lead thorough investigations, develop and execute claim strategies, and ensure fair, timely resolutions. The ideal candidate will possess an active California Workers’ Compensation Adjuster License and demonstrated experience handling litigated claims from inception through resolution. This role also offers a strong development pathway for advancement into more senior claim positions. You will play a key role in delivering exceptional service to CCMSI clients, fostering strong client relationships, and upholding our high standards of quality, responsiveness, and claims excellence.
This is a full lifecycle WC adjuster position within a TPA environment, and only candidates with proven Workers’ Compensation claims experience will be considered.
Responsibilities
When 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.
- 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.
Qualifications
Required Qualifications
- 5+ years of California Workers’ Compensation claims experience.
- Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
- California Adjuster's license is required.
Preferred Qualifications
- Bachelor’s degree is preferred but not required.
- 2+ Experience handling high complexity workloads.
Why You’ll 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 – thorough investigations, strong documentation, well-supported decisions
- Compliance & audit performance – adherence to jurisdictional and client standards
- Timeliness & accuracy – purposeful file movement and dependable execution
- Client partnership – proactive communication and strong follow-through
- Professional judgment – owning outcomes and solving problems with integrity
- Cultural alignment – 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 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. 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.
Our Core Values
At CCMSI, we believe in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who:
- Lead with transparency We build trust by being open and listening intently in every interaction.
- Perform with integrity We choose the right path, even when it is hard.
- Chase excellence We set the bar high and measure our success. What gets measured gets done.
- Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
- Win together Our greatest victories come when our clients succeed.
We don’t just work together—we grow together. If that sounds like your kind of workplace, we’d love to meet you.
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