California Comp Insurance Adjuster

Workers' Compensation Claim Specialist
Location: Irvine, CA - reporting remotely Schedule: Mon - Fri 8:00 am - 4:30 pm (PST - flexible start time)
Salary Range: $88,000 - $92,000 (depending on experience)

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.

We are seeking a driven and compassionate Workers' Compensation Claim Specialist to join our team and make a meaningful impact in the lives of injured workers. In this role, you will take ownership of a dedicated portfolio of claims for a single PEO account
, leading investigations, determining compensability, and guiding each case toward fair and timely resolution. This dedicated-account structure allows you to develop strong client relationships, gain in-depth knowledge of the client's operations, and become a trusted claims partner.

This position offers the opportunity to grow your technical expertise and can serve as an advanced development path for future supervisory or management roles. As a Claim Specialist, you play a vital role in delivering the high-quality service our clients count on and upholding CCMSI's commitment to excellence.

When we hire Workers’ Compensation Adjusters at CCMSI, we look for detail‑driven problem‑solvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust.

• Investigate, evaluate and adjust claims in accordance with established claim handling standards and applicable laws.
• Establish reserves within assigned authority levels and provide notice of qualifying claims to excess or reinsurance carriers when appropriate.
• Review, approve and oversee medical, legal, damage estimates, invoices and other external vendor services to ensure they are reasonable, necessary and related to designated claims. Negotiate disputed bills and supervise referrals to outside vendors.
• Authorize and issue claim payments in accordance with claim procedures, industry standards and established authority levels.
• Negotiate settlements in accordance with Corporate Claim Standards, client-specific handling instructions and applicable laws.
• Review and maintain claim diaries within the claim management system.
• Assess and monitor subrogation opportunities through resolution.
• Compute disability rates in accordance with applicable state laws.
• Maintain effective and timely communication with clients, claimants and other stakeholders while ensuring compliance with Corporate Claim Handling Standards and client-specific handling instructions.

Required:

• 5+ years of California Workers’ Compensation claims handling experience
  , including full claim investigation, evaluation, and resolution.
• Must
  be able to travel one time a year.
• SIP and CA adjusters license is required.
• Experience handling litigated and lost time claims.
• Responsiveness to internal and external client needs.
• Strong analytical and negotiation abilities.
• Knowledge of all lower‑level claim position responsibilities.

Nice to Have:

• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
• Ex…