Workers' Claim Representative II

Overview

Workers' Comp Claim Adjuster II (Hybrid) - Nevada

Location: Las Vegas, NV
Schedule: 8:00am - 4:30pm (PST)

Salary Range: 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.

Responsible for conducting thorough investigations and administering assigned workers’ compensation claims. This role also serves as a development position with potential advancement into senior‑level claims roles. Ensures high‑quality claim handling in accordance with CCMSI’s corporate standards and the service expectations of our clients.

Please note:

This is not an HR, administrative, consulting, or advisory support role. This is a true adjusting position. Candidates must have proven experience conducting full investigation, evaluation, negotiation, and resolution of workers’ compensation claims, with end-to-end file ownership and decision-making authority. Applicants without direct claims adjusting experience will not be considered.

• Investigate and adjust workers’ compensation claims in accordance with CCMSI procedures, industry standards, and supervisor guidance.
• Review medical, legal, and related invoices to confirm reasonableness and claim relevance; negotiate disputed bills as needed.
• Authorize and process claim payments using approved systems, ensuring accuracy and adherence to settlement authority levels.
• Negotiate claim settlements with injured workers and attorneys in alignment with client authorization and company guidelines.
• Assist in selecting, directing, and monitoring defense counsel.
• Evaluate and track subrogation opportunities to support recovery efforts.
• Prepare detailed reports on claim activity, payments, and reserve recommendations.
• Provide required reporting and file monitoring for excess insurance carriers.
• Meet established team service commitments and performance standards.
• Deliver high‑quality claim service and maintain strong client relationships.

What You’ll Bring

Required

• Excellent oral and written communication skills.
• Self‑starter with strong organizational skills and the ability to coordinate and prioritize tasks effectively.
• Demonstrated flexibility, initiative, and ability to work with minimal direct supervision.
• Ability to maintain discretion and confidentiality at all times.
• Strong teamwork skills and the ability to work effectively in a fast‑paced, changing environment.
• Reliable and predictable attendance during client service hours.
• Responsiveness to internal and external client needs.
• Ability to communicate clearly and professionally, both verbally and in writing.
• 5–10 years of experience in claims handling or equivalent education, with proven performance in claims management.

• Nice To Have - Billingual (Spanish) proficiency; highly valued for communicating (written and verbal) with claimants, employers, or vendors, but not required.

• Preferred Qualifications - Prior experience with Nevada-only WC claim handling; professional designations such as AIC, ARM, or CPCU.

• 4 weeks of paid time off plus 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

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…