Senior Workers’ Compensation Adjuster – Remote (CA Jurisdiction)

Overview

Workers’ Compensation Claim Specialist – Remote (CA Jurisdiction Only)

Reporting Location: Concord, CA BranchSchedule: Monday–Friday, 8:00 a.m. – 4:30 p.m. PSTCompensation: $85,000 – $97,000 annuallyWork Setting: Remote (must reside in a location that supports CA claim handling)

Build Your Career With Purpose

At CCMSI, we look for the brightest and most dedicated professionals to join our employee-owned team. As one of the nation’s leading Third Party Administrators in self-insurance services, we pride ourselves on providing exceptional service, innovative solutions, and a culture that values every employee’s contribution.

 

We are seeking an experienced California Workers’ Compensation Claim Specialist to join our remote team supporting the Concord, CA branch. This position manages a multiple-account desk handling California jurisdiction only and requires advanced claim handling knowledge, attention to detail, and the ability to balance multiple priorities in a fast-paced environment.

 

Job Summary

The Workers’ Compensation Claim Specialist is responsible for investigating, evaluating, and resolving a variety of complex California workers’ compensation claims in accordance with CCMSI’s best practices, state regulations, and client-specific service standards.

 

This position is ideal for a skilled adjuster seeking a long-term career with an employee-owned company that invests in training, technology, and its people.

 

Important – Please Read Before Applying

This is not an HR, benefits, safety, or manufacturing management role. We are seeking an insurance claims professional with proven experience directly investigating, reserving, litigating, and settling complex workers' compensation claims as an adjuster or adjuster supervisor within an insurance carrier, TPA, or similar claims-handling environment. Candidates without this background (for example, those with HR-only, safety, or employer-side risk management experience) will not be considered.

 

 

Responsibilities

• Investigate, evaluate, and adjust workers’ compensation claims within California jurisdiction in compliance with applicable laws and CCMSI standards.

• Establish and maintain appropriate reserves; authorize or recommend reserves and payments within assigned authority levels.

• Review, negotiate, and approve medical, legal, and other invoices as appropriate.

• Coordinate communication among claimants, clients, attorneys, and medical professionals to ensure timely and effective claim resolution.

• Attend and participate in hearings, mediations, and legal conferences as required.

• Prepare and maintain accurate, detailed claim documentation in compliance with corporate and client requirements.

• Monitor subrogation and excess/reinsurance claims as applicable.

• Deliver high-quality, client-focused service aligned with CCMSI’s commitment to excellence.

 

Qualifications

Required:

• 10+ years of progressively responsible experience adjusting California workers’ compensation claims.

• Demonstrated knowledge of California WC statutes, regulations, and case law.

• Exceptional written and verbal communication skills.

• Strong organization, multitasking, and time management abilities.

• Proficiency in Microsoft Office (Word, Excel, Outlook).

• Reliable, predictable attendance during client service hours.

Preferred:

• SIP certification and/or California Adjuster Certification.

• AIC designation or other industry credentials.

• Prior experience with Third Party Administrator (TPA) claims handling.

How We Measure Success

• Consistent compliance with CCMSI’s claim handling standards and state regulations.

• Supervisor review of claim quality and timeliness.

• Positive client feedback and adherence to service level expectations.

• Achievement of key audit and performance goals.

What We Offer

• 4 weeks PTO + 10 paid holidays in your first year• Medical, Dental, Vision, Life, and Disability Insurance• 401(k) and Employee Stock Ownership Plan (ESOP)• Internal training and advancement opportunities• 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 wi