Experienced WC Claim Adjuster California ADR Program (CA | Remote | SIP Required)

Workers' Compensation Claim Consultant

Location : Remote Reporting to California Jurisdiction

Schedule : MondayFriday, 8 : 00 AM4 : 30 PM PT

Salary Range : $80,000$85,000 annually

Build Your Career With Purpose at CCMSI

At CCMSI, we don't just process claimswe support people. As a leading Third Party Administrator and a certified Great Place to Work, we offer manageable caseloads, employee ownership, and a collaborative culture. Our employee-owners are empowered to grow, contribute, and make a meaningful impact.

Job Summary

The Workers' Compensation Claim Consultant is responsible for handling California workers' compensation claims for a single dedicated Alternate Dispute Resolution (ADR) client account. This role requires California jurisdiction experience and an active CA Adjuster's License, along with the Self-Insurance Administrator Certificate (SIP). You'll join a team of 10 adjusters and play a key role in ensuring quality claim handling through compliance with client guidelines, state laws, and CCMSI claim standards.

Performance is measured by accuracy, timeliness, and client satisfaction, with a focus on no penalties, current diary management, complete documentation, and timely payments.

Responsibilities

• Investigate, evaluate, and adjust assigned California workers' compensation claims in compliance with jurisdictional requirements and ADR processes.
• Establish and monitor reserves, authorize claim payments, and negotiate settlements within authority and client guidelines.
• Review medical, legal, and vendor invoices to confirm accuracy and appropriateness.
• Maintain thorough documentation and diary updates in the claim system.
• Communicate effectively with clients, claimants, and involved parties throughout the claim process.
• Participate in claim reviews, hearings, and mediations as needed.
• Ensure compliance with state laws, CCMSI claim handling standards, and client-specific requirements.

Qualifications

Required

Nice to Have

What We Offer

Compensation & Compliance

The posted hourly rate 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.

Visa Sponsorship

CCMSI does not provide visa sponsorship for this position.

ADA Accommodations

CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team.

Equal Opportunity Employer

CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment.

Our Core Values

At CCMSI, our Core Values guide how we work : integrity, client service, employee ownership, continuous improvement, collaboration, and enthusiasm for what we do.