Workers' Compensation Claim Adjuster

Overview

Workers' Compensation Claim Consultant

Location: Fully Remote (Reporting to Wall Township, NJ)Work Hours: Monday-Friday, 8:00 AM to 4:30 PMSalary: $80,000 - $85,000 per year

Jurisdictions: New York and New Jersey

At CCMSI, we’re looking for a skilled, detail-oriented, and experienced Workers' Compensation Claim Consultant to join our team remotely. This role serves multiple client accounts across New York and New Jersey jurisdictions, making it essential to have a deep understanding of New York Workers’ Compensation laws. As an Employee-Owned Third Party Administrator, CCMSI fosters a collaborative environment where your contributions are valued, and your career growth is supported.

Why You’ll Love Working Here

Collaborative Culture: Join a team that values integrity, enthusiasm, and teamwork.Remote Flexibility: Fully remote position providing excellent work-life balance.Professional Growth: Handle diverse accounts and jurisdictions, with opportunities for career advancement.

Responsibilities

What You’ll Do

As a Workers' Compensation Claim Consultant, you’ll manage claims from investigation through resolution within New York and New Jersey jurisdictions. This desk handles multiple accounts accross varies industries.  Key responsibilities include:

• Claims Adjustment: Investigate, evaluate, and adjust workers' compensation claims in compliance with NY and NJ laws, as well as client-specific guidelines.
• Reserve Management: Establish and recommend reserves within established authority levels.
• Billing Oversight: Analyze medical, legal, and damage invoices for reasonableness and negotiate disputed bills as necessary.
• Claim Payments: Authorize and process payments in accordance with industry standards and settlement authority.
• Settlements: Negotiate settlements with claimants and attorneys, ensuring compliance with state laws and client authorizations.
• Vendor Collaboration: Partner with defense attorneys and manage relationships with external vendors for legal, surveillance, and case management services.
• Reporting: Prepare detailed reports on claim statuses, payments, and reserves, and provide updates for excess insurers.
• Service Excellence: Deliver exceptional claim services to CCMSI clients, adhering to our corporate standards.
• Hearings & Legal Proceedings: Represent CCMSI at hearings, mediations, and legal conferences as needed.

Qualifications

What You Bring to the Table

Must-Have Skills:

• 5+ years of experience handling New York Workers’ Compensation claims.
• Deep knowledge of New York Workers’ Compensation laws.
• New York Adjuster’s License (required).
• Strong organizational skills with the ability to prioritize multiple tasks effectively.
• Proficiency in Microsoft Office (Word, Excel, Outlook).
• Excellent written and verbal communication skills.

Nice-to-Have Skills:

• Experience managing claims across multiple jurisdictions.

Ready to Elevate Your Career?

This is an exciting opportunity to grow your expertise in claims management while contributing to the success of a dynamic, nationwide organization. If you’re ready to take the next step in your career, apply today and join our exceptional team at CCMSI!

CCMSI is an Affirmative Action / Equal Employment Opportunity employer offering an excellent benefits package, including Medical, Dental, Vision, Prescription Drug, Life, ESOP, 401K, Flexible Spending, and more. CCMSI conducts background checks in accordance with applicable federal, state, and local laws.

Disclaimer: The posted salary range reflects the anticipated base pay for this role. Actual pay will depend on factors such as qualifications, experience, and internal equity. Additional compensation may include bonuses, benefits, or other forms of pay. This range complies with state and local transparency laws. Please discuss any questions about compensation or benefits with our hiring team.

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