Overview

Work Comp Claim Rep II (Bilingual - Spanish) 

 

Location: Irvince, CA - Remote (Must reside in a location that allows regular travel to Irvine, CA a few times per year)

Schedule:  Monday–Friday, 8:00 a.m. – 4:30 p.m. PST (37.5 hours per week)

Salary Range:  $70,000 – $80,000 annually (commensurate with experience)

 

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

 

We’re seeking a Workers’ Compensation Claim Representative II to handle California WC claims for a single carrier client. This is a great role for an experienced adjuster who is confident with full claim ownership—from investigation to resolution—and who thrives in a fast‑paced environment. 

 

This position requires excellent communication skills, strong technical knowledge of CA Workers’ Compensation, and the ability to work independently while remaining connected to a supportive team of fewer than 20 colleagues.

 

Bilingual English/Spanish proficiency (spoken & written) is required, and used regularly in claimant, employer, and provider communication.

 

Responsibilities

When we hire adjusters, we look for professionals who take ownership of their work, navigate complexity with confidence, and deliver exceptional service with integrity. In this role, you’ll be trusted to manage your files independently while contributing to a collaborative, high‑performing team.

What You’ll Do

• Investigate, evaluate, and adjust California workers’ compensation claims in alignment with jurisdictional requirements and CCMSI standards
• Communicate clearly with injured workers, employers, providers, attorneys, and other stakeholders
• Review, approve, and negotiate medical, legal, and miscellaneous invoices
• Determine compensability and authorize benefits within settlement authority
• Negotiate settlements with claimants and attorneys
• Coordinate and supervise defense counsel as needed
• Handle subrogation opportunities and ensure proper recovery efforts
• Prepare detailed reports on claims, reserves, and financial activity
• Monitor files for excess reporting requirements
• Maintain timely diary queues, document queues, and respond to audit standards
• Support client service commitments with accuracy and urgency

 

 

Qualifications

Required:

• Active California Adjuster License and/or SIP
• 5–10 years of workers’ compensation claim adjusting experience
• Bilingual (English/Spanish) — spoken and written
• Strong organizational skills and ability to prioritize in a fast‑paced environment
• Excellent verbal and written communication skills
• Proficiency in Microsoft Office (Word, Excel, Outlook)
• Ability to work independently with minimal supervision
• Ability to travel to the Irvine, CA office a few times per year

Nice to Have:

• Experience working with carrier clients
• High-volume caseload experience

 

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 performanc