Workers' Claim Consultant

Overview

Workers' Compensation Claim Consultant

Location: Las Vegas, NV

Schedule: 8:00 am - 4:30pm (Hybrid Schedule - 4 days in-office, 1 day work from home)

Salary Range: $65,000 - $85,000

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 Nevada 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.

This is a full life‑cycle WC adjuster position within a TPA environment, and only candidates with proven Workers’ Compensation claims experience will be considered.

• 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, and miscellaneous invoices to determine if reasonable and related to designated claims.
• 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 with 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 (e.g. legal, surveillance, case management).
• 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.
• Prepare newsletter articles, as requested.
• 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.
• Coordinate with defense counsel to ensure appropriate representation at hearings, mediations, and informal legal conferences, as appropriate.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

• 5+ years of Workers’ Compensation claims experience.
• Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
• Nevada Adjuster’s license required.
• Excellent written and oral communication.
• Ability to work alone or in a team setting.

• 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…