Workers’ Compensation Claim Rep I (CA Expertise Required)
CCMSI is a global leader in risk management solutions, seeking a Workers’ Compensation Claim Representative I to handle California workers’ compensation claims. The role involves investigating claims, managing medical and legal activities, and ensuring compliance with regulations while providing excellent service to clients. Responsibilities Investigate and adjust California workers’ compensation claims in accordance with CCMSI standards and client handling instructions Manage claims cradle-to-grave, including compensability decisions, medical management, and resolution strategy Review medical, legal, and miscellaneous invoices for accuracy, reasonableness, and claim-relatedness Negotiate disputed medical bills and work toward timely resolution Authorize and issue claim payments within assigned settlement authority Communicate with injured workers, employers, attorneys, medical providers, and internal partners Assist with settlement negotiations in accordance with client authorization Support the selection and coordination of defense counsel as appropriate Evaluate and monitor subrogation opportunities Prepare claim reports, payment summaries, and reserve documentation Maintain compliance with service commitments, jurisdictional requirements, and excess reporting obligations Deliver consistent, high-quality claim service aligned with CCMSI’s corporate standards Skills 1–3 years of workers' compensation claims experience or related experience in insurance, medical claims, legal, or adjacent claim-support roles Working knowledge of the California workers' compensation claims process Strong organizational, communication, and time-management skills Ability to prioritize work, meet deadlines, and manage multiple tasks Reliable, predictable attendance within established client service hours SIP designation or ability to obtain within a defined timeframe Associate degree or higher Experience supporting PEO and/or staffing accounts Proficiency with Microsoft Word, Excel, Outlook, and claims systems Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required Benefits 4 weeks PTO + 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 Company Overview CCMSI is a third-party administrator for workers' compensation and property/casualty self-insurance programs. It was founded in 1978, and is headquartered in Danville, Illinois, USA, with a workforce of 1001-5000 employees. Its website is