Workers' Compensation Claim Representative II

Overview

Workers' Compensation Claim Representative II
Location: Reno, NV - Hybrid schedule after initial training.
Schedule: 7:30am - 4:00pm (PST)
Salary Range: $60,000 - $72,000 (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 an experienced and motivated Nevada
Workers’ Compensation Claim Representative II to manage a diverse portfolio of claims with professionalism, empathy, and strong technical skill. With 5–10 years of experience, you’ll bring seasoned judgment to claim investigations, compensability decisions, and timely resolution strategies. This role provides an excellent opportunity to deepen your expertise and serves as a developmental step toward more senior claim positions. As a Claim Representative II, you’ll play a key role in delivering an exceptional client experience and upholding CCMSI’s high standards for quality claim service.

• Investigate and adjust workers compensation claims in accordance with established claims handling procedures using CCMSI guidelines and direct supervision.
• Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing workers compensation claims. Negotiate any disputed bills for resolution.
• 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.
• 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.

Required Qualifications

• 5+ years of Workers' Compensation claims management experience, or an equivalent combination of education and experience.

• Current Nevada Adjuster's License required.
• Strong organizational, prioritization, and multitasking skills with the ability to work independently.
• Excellent verbal and written communication skills.
• Ability to maintain confidentiality and exercise sound judgment.
• Proven ability to thrive in a fast-paced, changing environment and work effectively as part of a team.
• Customer-focused with a commitment to responsive service.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).

• Associate degree is preferred but not required.
• Experience handling multiple accounts of various industries.
• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.

Why You’ll Love Working Here

• 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

How We Measure Success

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 and client standards
• Timeliness & accuracy – purposeful file movement and dependable execution
• Client partnership – proactive communication and…