Workers’ Compensation Claim Representative I (or II)

Location: Remote – Reports to Irvine, CA
Schedule: Monday–Friday, 8:00 AM–4:30 PM PST (37.5 hours/week)
Salary Range: $58,000–$80,000 annually

Build Your Career With Purpose at CCMSI

At CCMSI, we don’t just process claims—we support people. As a leading Third Party Administrator and certified Great Place to Work®, we combine employee ownership, manageable caseloads, and a collaborative culture. Our employees are empowered to deliver quality outcomes and grow their careers in a supportive, remote-first environment.

Job Summary

We’re seeking an experienced Workers’ Compensation Claim Representative I to handle California jurisdiction claims for a single dedicated client account. If we cannot identify the right candidate at the Rep I level, we may consider hiring at the Claim Representative II level.

This role requires a California SIP certification and at least 3 years of workers’ compensation adjusting experience. All claim reviews, client meetings, and trainings are conducted virtually—no travel required.

Please note: This is a full adjuster role handling California workers’ compensation claims. It is not an HR, employer-side risk management, or administrative role.

What You’ll Do

• Investigate, evaluate, and adjust California workers’ compensation claims in accordance with CCMSI and client standards

• Review medical, legal, and miscellaneous invoices to confirm accuracy and negotiate disputed bills as needed

• Authorize and issue claim payments within settlement authority and industry standards

• Negotiate settlements with claimants and attorneys in line with client handling instructions

• Oversee and collaborate with defense attorneys, subrogation partners, and other vendors

• Prepare reports detailing claims status, payments, and reserves for client and excess insurers

• Ensure timely and accurate claim documentation and compliance with audit standards

• Deliver exceptional customer service to the client and injured workers

What You’ll Bring

Required:

• 3+ years of California workers’ compensation adjusting experience

• Active California SIP certification (required)

• Associate degree minimum (Bachelor’s degree preferred)

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

• Strong organizational skills and ability to manage multiple priorities in a remote environment

• Excellent written and verbal communication skills

Nice to Have:

• Experience with Alternative Dispute Resolution (ADR)

• Prior experience handling complex/litigated workers’ compensation claims

How We Measure Success

• Compliance with California jurisdictional standards and SIP requirements

• File quality and accuracy of reserves, payments, and documentation

• Client service and responsiveness to needs

• Audit results and adherence to CCMSI best practices

What We Offer

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

• Medical, Dental, Vision, Life, and Disability Insurance

• 401(k) and Employee Stock Ownership Plan (ESOP)

• Remote work with predictable hours (PST alignment)

• Career development and opportunities for promotion (Rep I → Rep II → Consultant/Senior roles)

• Supportive team culture with virtual collaboration and mentorship

Compensation & Compliance

The posted wage reflects CCMSI’s good-faith estimate in accordance with applicable pay transparency laws. Actual pay will be based on experience, qualifications, and internal equity. This role may also be eligible for additional compensation or bonuses.

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, 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

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

Ready to build your career with purpose? Apply today to join CCMSI as a Workers’ Compensation Claim Representative I (or II) and bring your California SIP expertise to a dedicated client account.

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