Position Title: Workers’ Compensation Claim Specialist
Location: Remote – Reporting to Concord, CA
Schedule: Monday–Friday, 8:00 AM to 4:30 PM PST
Salary Range: $85,000–$100,000 annually
Jurisdiction: California only (CA Certification & SIP required)
Desk Type: Multi-account desk within insurance captive
Travel Required: None
Performance Metrics: Internal audit compliance
At CCMSI, we don’t just adjust claims—we support people. As a leading Third Party Administrator (TPA) and a certified Great Place to Work®, we’re proud to be 100% employee-owned. We prioritize manageable caseloads, structured development, and meaningful career growth. Our culture is collaborative and client-focused, and our employee satisfaction consistently ranks in the 95th percentile.
We are seeking an experienced Workers’ Compensation Claim Specialist with hands-on expertise in California jurisdiction. In this role, you will manage a multi-account desk within an insurance captive, handling complex WC claims from start to finish. You’ll ensure compliance with California workers’ compensation laws, SIP standards, and CCMSI best practices, with performance measured through internal audit results.
Important – Please Read Before Applying
This is not an HR, benefits, safety, or manufacturing management role. We are seeking an insurance claims professional with proven experience directly investigating, reserving, litigating, and settling California WC claims as an adjuster or adjuster supervisor within an insurance carrier, TPA, or similar environment. Candidates without this background will not be considered.
Investigate, evaluate, and adjust California WC claims in compliance with laws, SIP standards, and CCMSI best practices.
Establish reserves and provide oversight within authority levels.
Manage litigation, including strategy, settlement negotiations, and vendor oversight (attorneys, case management, surveillance, etc.).
Review, approve, and negotiate medical, legal, and miscellaneous invoices.
Ensure timely and accurate indemnity payments and documentation.
Communicate effectively with clients, claimants, providers, and legal teams throughout the claim process.
Monitor subrogation claims and resolve as appropriate.
Attend hearings, mediations, and client reviews as required.
Maintain diary compliance and file quality in alignment with audit standards.
10+ years of California WC adjusting experience required.
SIP certification required.
Prior TPA experience helpful but not required.
Excellent oral/written communication, analytical, and negotiation skills.
Strong organizational skills with the ability to manage a multi-account desk.
Proficiency in Microsoft Office (Word, Excel, Outlook).
Bachelor’s degree preferred but not required.
File audit scores
Customer satisfaction and responsiveness
Claims management outcomes
Timely and accurate indemnity payments
Generous PTO: 4 weeks in your first year + 10 paid holidays
Comprehensive Benefits: Medical, Dental, Vision, Life Insurance, 401(k), and ESOP (employee ownership)
Professional Development: Robust training and advancement opportunities
Work Environment: Remote flexibility with strong team collaboration and support
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. This role may also qualify for bonuses or additional forms of pay.
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:
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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