Workers' Compensation Claim Adjuster - Sr. Level (Remote) CA Claims

Overview

Workers' Compensation Adjuster (Senior Level)- Remote Location: Irvine, CA (reporting remotely) Schedule: 8:00am - 4:30pm (PST) Work Type: Full-time Salary Range: $75,000 - $99,000 Client Type: Multiple Clients - Full Cycle Claim Handling Build Your Career With Purpose at CCMSI At 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 This experienced Workers’ Compensation Claim Adjuster position is responsible for investigating, evaluating, and resolving assigned workers’ compensation claims. This role may also serve as an advanced developmental position for individuals seeking future supervisory or management opportunities. Additionally, the Claim Specialist is accountable for delivering high‑quality claim services that meet CCMSI’s corporate standards and uphold the level of service our clients expect.

Responsibilities

• Investigate, evaluate, and adjust workers’ compensation claims in compliance with established standards, procedures, and applicable laws.
• Set claim reserves or provide reserve recommendations within assigned authority levels.
• Review, approve, or oversee medical, legal, damage, and miscellaneous invoices to ensure they are reasonable and related to the claim; negotiate disputed bills when necessary.
• Authorize and process claim payments according to established guidelines, industry standards, and assigned payment authority using the claim payment system.
• Negotiate settlements in accordance with Corporate Claim Standards, client-specific instructions, and state regulations when appropriate.
• Assist in selecting, referring, and supervising outside service providers (e.g., legal counsel, surveillance vendors, case management).
• Maintain an organized and up‑to‑date personal diary within the claim system to track ongoing file activity.
• Assess and pursue subrogation opportunities to ensure timely recovery.
• Calculate disability rates in compliance with state laws and guidelines.
• Provide timely, effective communication with clients, claimants, and other involved parties throughout the claim lifecycle.
• Submit required notices for qualifying claims to excess and reinsurance carriers.
• Adhere to Corporate Claim Handling Standards and follow all special client instructions.

Qualifications

Required:

• Minimum of 5 years of workers’ compensation claim adjusting experience.
• Proficiency in Microsoft Office (Word, Excel, Outlook).
• Strong written and verbal communication skills.
• Proven ability to manage deadlines and multiple priorities effectively.
• California jurisdiction experience required.

Nice to Have:

• Billingual (Spanish) proficiency- highly valued for communication with claimants, employers, or vendors, but not required.

Preferred:

• California SIP certification.
• Claim review presentation experience.
• AIC, ARM, or CPCU designation.

Why You'll Love Working Here

• 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
• Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
• Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
• Career growth: Internal training and advancement opportunities
• Culture: A supportive, team-based work environment

How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:

• Quality claim handling – thorough investigations, strong documentation, well-supported decisions
• Compliance & audit performance – adherence to jurisdictional and client standards
• Timeliness & accuracy – purposeful file movement and dependable execution
• Client partnership – proactive communication and strong follow-through
• Professional judgment – owning outcomes and solving problems with integrity
• Cultural alignment – believing every claim represents a real person and acting accordingly

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 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. CCMSI posts internal career opportunities in compliance with applicable state and local promotion transparency laws. 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. 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:

• 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 work place, we'd love to me you. Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkersCompensation #ClaimsAdjuster #RemoteJobs #CaliforniaJobs #InsuranceCareers #TransportationIndustry #LI-Remote Apply tot his job Apply To this Job