Workers' Compensation Claim Consultant

Workers' Compensation Claim Consultant Location: Las Vegas, NV (reporting remotely)Schedule: 8:00 am - 4:30pm (PST)Salary Range: $80,000 - $90,000 (depending on experience)Build Your Career With Purpose at CCMSIAt CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.We don't just process claims—we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.Job Summary Workers' Compensation Claim Consultant is responsible for investigating and managing assigned workers' compensation claims while delivering high-quality service aligned with company standards and client expectations. This role also serves as a developmental opportunity for advancement into more senior claims positions. This is a full life‐cycle WC adjuster position within a TPA environment, and only candidates with proven Workers' Compensation claims experience will be considered.Responsibilities Investigate, evaluate, and manage workers' compensation claims in compliance with applicable laws and company standardsEstablish and maintain appropriate claim reserves within authority limitsReview and approve medical, legal, and related expenses; resolve disputed invoices as neededAuthorize and process claim payments in line with procedures and industry standardsNegotiate settlements in accordance with company guidelines, client requirements, and state regulationsCoordinate with and oversee external vendors (e.g., legal, medical, surveillance, case management)Monitor subrogation opportunities and pursue recovery when applicableMaintain accurate claim documentation and follow-up activities within the claim systemCommunicate effectively with clients, claimants, and other stakeholders to ensure timely updates and resolutionPrepare claim reports, including status updates, payments, and reserve changesCalculate disability rates in accordance with state guidelinesHandle complex claims with minimal supervisionParticipate in hearings, mediations, and other legal proceedings as neededSupport client relationships through claim reviews, training sessions, and high-quality service deliveryEnsure compliance with corporate claim standards and client-specific handling instructionsQualifications RequiredCalifornia SIP or experienced adjuster licenseExcellent oral and written communication skills internally and externallyInitiative to set and achieve performance goals.Good analytic and negotiation skills.Ability to cope with job pressures in a constantly changing environment.Knowledge of all lower level claim position responsibilities.Must be detail oriented and a self-starter with strong organizational abilities.Ability to coordinate and prioritize required.Flexibility, accuracy, initiative and the ability to work with minimum supervision.Discretion and confidentiality required.Responsive to internal and external client needs.Nice to Have:Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not requiredExperience with handling lost time and litigated claimsPrior experience handling multiple accountsTPA experienceWhy You'll Love Working Here4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first yearComprehensive benefits : Medical, Dental, Vision, Life, and Disability InsuranceRetirement plans : 401(k) and Employee Stock Ownership Plan (ESOP)Career growth : Internal training and advancement opportunitiesCulture : A supportive, team-based work environmentHow We Measure SuccessAt CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:Quality claim handling – thorough investigations, strong documentation, well-supported decisionsCompliance & audit performance – adherence to jurisdictional and client standardsTimeliness & accuracy – purposeful file movement and dependable executionClient partnership – proactive communication and strong follow-throughProfessional judgment – owning outcomes and solving problems with integrityCultural alignment – believing every claim represents a real person and acting accordinglyThis is where we shine, and we hire adjusters who want to shine with us.Compensation & ComplianceThe 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.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.Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.Our Core ValuesAt 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.#EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #NevadaJobs #LasVegasJobs #CareerGrowth #InsuranceJobs #ESOP #IND123 #LI-Remote