Workers’ Compensation Claim Representative I

Location: Albuquerque, NM – Hybrid
Work Arrangement: 60 days in-office for training, then hybrid (2 in-office days / 3 remote days per week)
Schedule: Monday–Friday, 7:00 AM–3:00 PM or 8:00 AM–4:00 PM
Salary: $55,000 annually
Jurisdiction: New Mexico (NM) only
License/Certification Required: Active NM Adjuster License required
Client Type: Single dedicated school district account
Performance Metrics: Timely claim handling, documentation quality, compliance with diaries and client service standards, queue management
Growth Potential: Yes – potential advancement to Claim Rep II and beyond

Build Your Career with Purpose

At CCMSI, our Workers’ Compensation Claim Representatives do more than process claims—they play a vital role in supporting injured workers and ensuring exceptional service to our clients.

As one of the largest employee-owned Third Party Administrators (TPA) in the nation, we specialize in workers’ compensation, liability, and multi-line claims management for self-insured organizations. Our clients trust us to deliver high-quality service with integrity, compassion, and expertise.

As a 100% employee-owned company and a Great Place to Work® Certified organization, we prioritize our people. We invest in structured career development, reward contributions, and provide resources so employees can thrive. Our employee satisfaction and retention consistently rank in the 95th percentile.

Job Summary

We’re seeking a Workers’ Compensation Claim Representative I to join our Albuquerque team. This role manages indemnity claims—including legal, questionable, and complex cases—in the New Mexico jurisdiction for a single dedicated school district client.

The ideal candidate will bring prior WC adjusting experience, strong organizational skills, and the ability to balance empathy with sound judgment in claim resolution.

Key Responsibilities

• Investigate and adjust NM workers’ compensation indemnity claims according to CCMSI standards and client-specific instructions

• Establish and monitor reserves, authorize payments, and ensure compliance with settlement authority levels

• Review and approve medical, legal, and miscellaneous invoices; negotiate disputed bills when needed

• Negotiate settlements with claimants and attorneys in line with client authorization

• Coordinate and oversee defense counsel as needed

• Pursue and monitor subrogation recoveries

• Prepare timely reports on claims, reserves, and payments for clients and excess insurers

• Maintain accurate, up-to-date documentation, diaries, and file notes for compliance and audits

• Deliver timely and high-quality claim service to clients

Required:

• Required: Active New Mexico Adjuster License

• Required: 3+ years of prior WC adjusting experience (indemnity)

• Excellent oral and written communication skills

• Strong organizational and negotiation abilities

• Proficiency in Microsoft Office (Word, Excel, Outlook)

Nice to Have:

• Experience handling claims for schools or public entities

• Knowledge of Medical Terminology

What We Offer

• Generous PTO: 4 weeks in your first year + 10 paid holidays

• Comprehensive Benefits: Medical, Dental, Vision, Life Insurance, 401(k), and ESOP

• Professional Development: Robust training, advancement paths, and employee ownership

• Work Environment: Supportive, inclusive culture with hybrid flexibility

Compensation & Compliance

The 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. 

CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits.

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, we believe in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who:

• Act with integrity
• Deliver service with passion and accountability
• Embrace collaboration and change
• Seek better ways to serve
• Build up others through respect, trust, and communication
• Lead by example—no matter their title
• Employee ownership mindset

We don’t just work together—we grow together. If that sounds like your kind of workplace, we’d love to meet you.

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