Overview

Position Title: Workers' Compensation Claim Consultant (MA, CT, RI)Location: Reading, MA (Hybrid reporting after training duration)Schedule: 8:00 am-4:30 pm ETSalary Range: $85,000-$95,000

Job Summary

We are seeking an experienced and highly skilled Workers Compensation Claim Consultant to manage a complex portfolio of claims with confidence, empathy, and sound professional judgment. With 5+ years of handson claims experience, you will lead thorough investigations, guide claim strategy, and ensure fair, timely resolutions. This role also offers a strong development pathway for advancement into more senior claim positions. As a Claim Consultant, you will play a key role in delivering exceptional service to CCMSI clients and upholding our high standards of quality and responsiveness. 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

• Five or more years of Workers Compensation claims experience.
• Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
• Adjusters license:CT, RI

Preferred Qualifications

• Bachelors degree is preferred but not required.
• Bilingual (Spanish) proficiency highly valued for communicating with claimants, employers, or vendors, 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.