Senior Workers’ Compensation Claims Adjuster (Remote, CA Jurisdiction)

Overview

Workers' Compensation Claim SpecialistRemote | Reporting to Irvine, CA BranchMonday - Friday, 8:00 AM - 4:30 PM PSTSalary Range: $85,000 - $99,000

Salary Disclaimer: The posted salary reflects the anticipated base pay for this role. Actual pay will depend on qualifications, experience, and internal equity. Additional compensation may include bonuses, benefits, or other forms of pay. Discuss compensation and benefits questions with our hiring team.

About CCMSI:CCMSI is a leading Third-Party Administrator (TPA) specializing in workers’ compensation and liability claims management. We are committed to delivering exceptional service and tailored solutions to our clients across various industries.

Position Overview:CCMSI is seeking an experienced Workers' Compensation Claim Specialist to join our team. This fully remote position reports to our Irvine, CA branch and manages a multiple-account desk within various industries, handling claims exclusively in the California jurisdiction. The ideal candidate will have 3+ years of experience managing indemnity claims in California, with a strong ability to review claims from onset to closure, maintain excellent diary management, process timely indemnity payments, and provide outstanding customer service. A California Self-Insurance Administrator (SIP) certification is highly preferred.

Responsibilities

• Investigate, evaluate, and adjust California workers’ compensation claims in accordance with CCMSI best practices and state regulations.

• Maintain excellent diary management to ensure proactive claim handling and timely resolution.

• Establish reserves and provide reserve recommendations within designated authority levels.

• Authorize and process timely indemnity payments and claim-related expenses per company standards.

• Ensure compliance with California workers’ compensation laws, corporate claim handling standards, and client-specific guidelines.

• Communicate effectively with claimants, clients, medical providers, attorneys, and other stakeholders throughout the claims process.

• Compute disability rates in accordance with California state law.

• Coordinate and oversee services provided by outside vendors, including legal counsel, surveillance, and case management when necessary.

• Assess and monitor subrogation claims for resolution.

• Provide notices of qualifying claims to excess/reinsurance carriers.

• Maintain compliance with all CCMSI reporting requirements and best practices.

• Potential travel 1-2 times per year for meetings or training.

Qualifications

Preferred Qualifications & Skills:

• 5+ years of experience handling indemnity claims within California.

• Strong analytical, negotiation, and communication skills.

• Ability to work independently and manage multiple claims efficiently.

• High attention to detail, organization, and initiative.

• …