Workers' Compensation Claim Representative II

Overview

Workers' Comp Claim Adjuster II (Hybrid) - Nevada

Location: Las Vegas, NV

Schedule: 8:00am - 4:30pm (PST)

Salary Range:

Build Your Career With Purpose at CCMSI

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.

Job Summary

Responsible for conducting thorough investigations and administering assigned workers’ compensation claims. This role also serves as a development position with potential advancement into senior‑level claims roles. Ensures high‑quality claim handling in accordance with CCMSI’s corporate standards and the service expectations of our clients.Please note: This is not an HR, administrative, consulting, or advisory support role. This is a true adjusting position. Candidates must have proven experience conducting full investigation, evaluation, negotiation, and resolution of workers’ compensation claims, with end-to-end file ownership and decision-making authority. Applicants without direct claims adjusting experience will not be considered.

Responsibilities

• Investigate and adjust workers’ compensation claims in accordance with CCMSI procedures, industry standards, and supervisor guidance.
• Review medical, legal, and related invoices to confirm reasonableness and claim relevance; negotiate disputed bills as needed.
• Authorize and process claim payments using approved systems, ensuring accuracy and adherence to settlement authority levels.
• Negotiate claim settlements with injured workers and attorneys in alignment with client authorization and company guidelines.
• Assist in selecting, directing, and monitoring defense counsel.
• Evaluate and track subrogation opportunities to support recovery efforts.
• Prepare detailed reports on claim activity, payments, and reserve recommendations.
• Provide required reporting and file monitoring for excess insurance carriers.
• Meet established team service commitments and performance standards.
• Deliver high‑quality claim service and maintain strong client relationships.

Qualifications

What You'll Bring

Required:

• Excellent oral and written communication skills.
• Self‑starter with strong organizational skills and the ability to coordinate and prioritize tasks effectively.
• Demonstrated flexibility, initiative, and ability to work with minimal direct supervision.
• Ability to maintain discretion and confidentiality at all times.
• Strong teamwork skills and the ability to work effectively in a fast‑paced, changing environment.
• Reliable and predictable attendance during client service hours.
• Responsiveness to internal and external client needs.
• Ability to communicate clearly and professionally, both verbally and in writing.
• 5–10 years of experience in claims handling or equivalent education, with proven performance in claims management.

Nice to Have:

• Billingual (Spanish) proficiency- highly cvalued for communicating (written and verbal) with claimants, employers, or vendors, but not required.

Preferred Qualifications

• Prior experience with Nevada- only WC claim handling
• Professional designations such as AIC, ARM, or CPCU

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 strong follow-through
• Professional judgment – owning outcomes and solving problems with integrity
• Cultural alignment – believing every claim represents a real person and acting accordingly

This is where we shine, and we hire adjusters who want to shine with us.

Compensation & Compliance

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 internal equity. This role may also qualify for bonuses or additional forms of pay.

CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.

CCMSI posts internal career opportunities in compliance with applicable state and local promotion transparency laws.

Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.

ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.

Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.

Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.

Our Core Values

At CCMSI, we believe in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who:

• Lead with transparency We build trust by being open and listening intently in every interaction.
• Perform with integrity We choose the right path, even when it is hard.
• Chase excellence We set the bar high and measure our success. What gets measured gets done.
• Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
• Win together Our greatest victories come when our clients succeed.

#EmployeeOwned #GreatPlaceToWorkCertified#WorkersComp #ClaimsJobs #NevadaJobs #AdjusterJobs #HybridJobs #InsuranceCareers #HiringNow #TPACareers #IND123 #LIHybrid

Need help finding the right job?