SIP-Certified Workers' Compensation Adjuster (Remote)
Job Summary
The Senior Workers' Compensation Claims Adjuster is responsible for investigating, evaluating, administering, and resolving California Workers' Compensation claims across multiple client programs. This role involves managing claims from assignment through closure while ensuring compliance with California workers' compensation laws, client-specific handling instructions, and CCMSI claim handling standards.
Responsibilities
- Investigate, evaluate, and adjust California Workers' Compensation claims from assignment through resolution
- Manage indemnity and medical exposures while developing effective claim strategies
- Handle litigated claims and collaborate with defense counsel throughout the litigation process
- Determine compensability and establish appropriate reserves
- Coordinate medical treatment, return-to-work efforts, and vocational considerations when applicable
- Maintain accurate file documentation and claim reporting
- Communicate regularly with injured workers, employers, attorneys, medical providers, and clients
- Maintain compliance with California Workers' Compensation regulations and client handling requirements
Qualifications
- Required Qualifications:
- California Workers' Compensation claims handling experience
- Self-Insured Administrator Certificate (SIP) required
- Strong understanding of California Workers' Compensation laws and regulations
- Experience handling litigated Workers' Compensation claims
- Experience managing claims from investigation through resolution
- Ability to independently manage a full caseload
- Strong reserve management and claim strategy skills
- Excellent verbal and written communication skills
- Strong negotiation and problem-solving abilities
- Ability to work independently in a remote environment
- Proficiency with Microsoft Office applications
- Reliable attendance during established business hours
- Preferred Qualifications:
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required
- Prior TPA experience is helpful
- Experience presenting files during client claim reviews is helpful
- Multi-client account experience
- Professional designations such as AIC, ARM, or CPCU are preferred 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
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.
Background Checks
Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.
Equal Opportunity Employer
CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.