Workers' Compensation Claim Adjuster (Hybrid) (Blended Desk - Medical and Indemnity)

Overview

Workers’ Compensation Claim Adjuster - Lost Time and Medical Only 

Location: Dublin, OH (Hybrid after training – will consider remote for the right candidate)Schedule: Monday–Friday, 8:00 AM to 4:30 PMSalary Range: $60,000 – $65,000 annually

After two weeks of in-office training, you’ll transition to a hybrid schedule (two days in the office, three days at home). For experienced candidates with strong Ohio jurisdiction knowledge, a remote option may be considered.

 

Build Your Career With Purpose at CCMSI

At CCMSI, we don’t just process claims—we support people. As one of the largest employee-owned Third Party Administrators in the country, 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

This role is responsible for the investigation, management, and resolution of both medical-only and lost-time Workers’ Compensation claims, ensuring compliance with Ohio state laws and CCMSI’s best practices. You’ll serve as the primary point of contact for your assigned client, delivering high-quality claim service, timely communication, and accurate documentation throughout the life of each claim.

 

Performance is measured by Best Practice scores, audit results, and client feedback.

Important Note:This position is not an HR, medical billing, or administrative role. It is a professional claim adjusting position requiring prior experience managing Workers’ Compensation claims, preferably within a Third-Party Administrator (TPA) environment.

 

Responsibilities

• Investigate, evaluate, and adjust Medical Only and Lost Time Workers’ Compensation claims in accordance with Ohio BWC and CCMSI guidelines.

• Establish reserves and authorize payments within assigned authority levels.

• Review, approve, and negotiate medical and legal expenses as appropriate.

• Evaluate medical documentation, determine compensability, and manage return-to-work efforts.

• Negotiate settlements with claimants, attorneys, and other stakeholders as authorized.

• Coordinate and communicate with defense counsel, medical providers, and employer representatives.

• Monitor and pursue subrogation opportunities.

• Prepare detailed and timely claim documentation, reports, and updates for both clients and excess carriers.

• Participate in periodic in-state travel for client claim reviews and meetings.

 

Qualifications

 

Required:

• Experience handling both Medical Only and Lost Time Workers’ Compensation claims.

• Strong understanding of Ohio Workers’ Compensation laws, regulations, and forms.

• Excellent organizational, communication, and analytical skills.

• Proficiency with Microsoft Office and claims management software.

• Ability to manage a caseload independently while collaborating with the team.

Preferred:

• Prior experience handling claims for medical or healthcare industry clients.

• Experience working in a Third-Party Administrator (TPA) environment.

• 2+ years of Workers’ Compensation adjusting experience.

• Associate degree or equivalent experience.

Training & Development

• Two weeks of structured in-office training followed by ongoing, hands-on mentorship.

How We Measure Success

• Accuracy and timeliness of claim handling and documentation.
• Quality of claim file audits and annual performance reviews.
• Positive client feedback and adherence to service standards.

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 will be based on qualifications, experience, geographic location, and internal equity. 

 

Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.ADA Accommodations: CCMSI is committed to providing