Workers' Compensation Claim Adjuster

About the role

Workers’ Compensation Claim Advocate (Adjuster) based in Lisle, IL (Hybrid – In office 2x/month after training). CCMSI is seeking talent to join the Illinois Public Risk Fund, the largest public entity workers’ compensation pool in Illinois, which has a dedicated CCMSI claims team of 21 staff and its own office space. As a leading third‑party administrator in self‑insurance services, CCMSI focuses on delivering exceptional service to clients, employee development through structured career programs, and maintains a Great Place To Work certification with employee satisfaction in the 95th percentile. The role offers career development via internships and internal training, and a work environment designed for employee satisfaction with manageable caseloads.

Responsibilities

• Investigate, evaluate and adjust workers’ compensation claims in accordance with established claim handling standards and laws.
• Establish reserves and/or provide reserve recommendations within established reserve authority levels.
• Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated workers’ compensation claims.
• Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of workers’ compensation claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
• Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
• Assist in the selection, referral and supervision of designated workers’ compensation claim files sent to outside vendors (e.g., legal, surveillance, case management, etc.).
• Review and maintain personal diary on claim system.
• Assess and monitor subrogation claims for resolution.
• Compute disability rates in accordance with state laws.
• Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the workers’ compensation claim adjustment process.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

Qualifications

• Excellent oral and written communication skills.
• Initiative to set and achieve performance goals.
• Good analytic and negotiation skills.
• Knowledge of all lower level claim position responsibilities.
• Detail oriented and a self‑starter with strong organizational abilities.
• Ability to coordinate and prioritize.
• Flexibility, accuracy, initiative and the ability to work with minimum supervision.
• Discretion and confidentiality required.
• Reliable, predictable attendance within client service hours.
• Responsive to internal and external client needs.
• Ability to clearly communicate verbally and/or in writing both internally and externally.
• 5‑10 years workers’