At CCMSI , we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile. Reasons you should consider a career with CCMSI: Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm. Career development: CCMSI offers robust internships and internal training programs for advancement within our organization. Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP. Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads. We are seeking a skilled Workers' Compensation Claim Adjuster to join our team in Arizona. This remote position requires residency in Arizona with periodic travel to our Scottsdale office for meetings. While possession of an Arizona Adjuster's license is preferred, it is not mandatory.
As a Workers' Compensation Claim Representative , you will be responsible for investigating and managing assigned workers' compensation claims. This role may serve as an advanced training opportunity for future advancement to senior-level claim positions within our organization. Your performance will directly impact the quality of claim services delivered to CCMSI clients and align with our corporate claim standards.
Key Responsibilities: Investigate, evaluate and adjust workers compensation claims in accordance with established claims handling procedures using CCMSI guidelines and direct supervision.
Collaborate with stakeholders including clients, medical providers, and legal representatives. Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing workers compensation claims. Negotiate any disputed bills for resolution.
Determine compensability and benefits entitlement based on applicable laws and company policies. Authorize and make payment of workers compensation claims utilizing a claim payment program in accordance with industry standards and within settlement authority.
Negotiate settlements with claimants and attorneys in accordance with client's authorization.
Maintain comprehensive claim documentation and updates in accordance with regulatory requirements. Assist in selection and supervision of defense attorneys.
Assess and monitor subrogation claims for resolution.
Prepare reports detailing claims, payments and reserves.
Provide reports and monitor files, as required by excess insurers.
Compliance with Service Commitments as established by team.
Delivery of quality claim service to clients.
Manage claims within designated authority and ensure timely resolution. Utilize effective communication skills to provide excellent customer service to clients and claimants. Collaborate with team members and supervisors to enhance claims handling strategies. Performs other duties as assigned.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Minimum of 3 years of experience in workers' compensation claims adjusting. Strong understanding of workers' compensation laws and regulations. Experience working with clients in the transportation and hospitality/restaurant industries is preferred. Excellent organizational skills with the ability to manage multiple claims concurrently. Effective verbal and written communication skills. Proficient in using claims management software and related tools. Availability to work Monday to Friday during core operating hours of 8:00 AM to 4:30 PM. Willingness to travel to the Scottsdale office as needed for meetings (approximately a couple of times per month). Ability to coordinate and prioritize required.
Flexibility, initiative, and the ability to work with a minimum of direct supervision a must.
Discretion and confidentiality required.
Ability to work as a team member in a rapidly changing environment.
Reliable, predictable attendance within client service hours for the performance of this position.
Responsive to internal and external client needs.
This position offers an opportunity to contribute to a dynamic team environment and provides a pathway for career advancement within the field of workers' compensation claims management. If you are a dedicated professional with a strong background in workers' compensation claims adjusting, we encourage you to apply and join our team at CCMSI.
Education and/or Experience Claim Rep will possess excellent claims management skills, typically with 3 to 10 years of experience or equivalent education, along with proven claims handling performance levels.
Computer Skills Proficient with Microsoft Office programs.
Certificates, Licenses, Registrations Adjuster's license is not required
CORE VALUES & PRINCIPLES Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.
CCMSI is an Affirmative Action / Equal Employment Opportunity employer offering an excellent benefit package including Medical, Dental, Prescription Drug, Vision, Flexible Spending, Life, ESOP and 401K.
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