Workers' Claim Adjuster

Job Overview

• Position Title:
  
  Workers' Compensation Claim Consultant (NJ, PA, MD, and DE)
• Location:
  
  Wall Township, NJ (Hybrid preferred, remote eligible)
• Schedule:
  
  8:00 am-4:30 pm ET
• Salary Range: $70,000-$90,000

We are seeking an experienced and highly skilled Workers' Compensation Claim Consultant to manage a complex portfolio of claims with confidence, empathy, and sound professional judgment. With 5+ years of hands‑on claims experience, you will lead thorough investigations, guide claim strategy, and ensure fair, timely resolutions. This role also offers a strong development pathway for advancement into more senior claim positions.

As a Claim Consultant, you will play a key role in delivering exceptional service to CCMSI clients and upholding our high standards of quality and responsiveness.

• Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
• Establish reserves and/or provide reserve recommendations within established reserve authority levels.
• Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
• Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
• Assist in the selection, referral and supervision of designated claim files sent to outside vendors (i.e. legal, surveillance, case management, etc.).
• Assess and monitor subrogation claims for resolution.
• Review and maintain personal diary on claim system.
• Client satisfaction.
• Prepare reports detailing claim status, payments and reserves, as requested.
• Compute disability rates in accordance with state laws.
• Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Handle more complex and involved claims than lower level claim positions with minimum supervision.
• Conduct claim reviews and/or training sessions for designated clients, as requested.
• Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

• Five or more years of Workers’ Compensation claims experience.
• Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
• Adjuster’s license may be required based on jurisdiction.
• States handled: NJ, PA, MD, and DE (DE preferred).

• Bachelor’s degree is preferred but not required.
• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.

• 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.

• 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.

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…