Workers’ Compensation Senior Adjuster – CA Jurisdiction (Remote)

Overview

Position Title: Workers’ Compensation Claim SpecialistLocation: Remote – Reporting to Concord, CASchedule: Monday–Friday, 8:00 AM to 4:30 PM PSTSalary Range: $85,000–$100,000 annuallyJurisdiction: California only (CA Certification & SIP required)Desk Type: Multi-account desk within insurance captiveTravel Required: NonePerformance Metrics: Internal audit compliance

Build Your Career with Purpose

At CCMSI, we don’t just adjust claims—we support people. As a leading Third Party Administrator (TPA) and a certified Great Place to Work®, we’re proud to be 100% employee-owned. We prioritize manageable caseloads, structured development, and meaningful career growth. Our culture is collaborative and client-focused, and our employee satisfaction consistently ranks in the 95th percentile.

 

Job Summary

We are seeking an experienced Workers’ Compensation Claim Specialist with hands-on expertise in California jurisdiction. In this role, you will manage a multi-account desk within an insurance captive, handling complex WC claims from start to finish. You’ll ensure compliance with California workers’ compensation laws, SIP standards, and CCMSI best practices, with performance measured through internal audit results.

 

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 California WC claims as an adjuster or adjuster supervisor within an insurance carrier, TPA, or similar environment. Candidates without this background will not be considered.

 

Responsibilities

 

• Investigate, evaluate, and adjust California WC claims in compliance with laws, SIP standards, and CCMSI best practices.

• Establish reserves and provide oversight within authority levels.

• Manage litigation, including strategy, settlement negotiations, and vendor oversight (attorneys, case management, surveillance, etc.).

• Review, approve, and negotiate medical, legal, and miscellaneous invoices.

• Ensure timely and accurate indemnity payments and documentation.

• Communicate effectively with clients, claimants, providers, and legal teams throughout the claim process.

• Monitor subrogation claims and resolve as appropriate.

• Attend hearings, mediations, and client reviews as required.

• Maintain diary compliance and file quality in alignment with audit standards.

 

Qualifications

 

Qualifications

• 10+ years of California WC adjusting experience required.

• SIP certification required.

• Prior TPA experience helpful but not required.

• Excellent oral/written communication, analytical, and negotiation skills.

• Strong organizational skills with the ability to manage a multi-account desk.

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

• Bachelor’s degree preferred but not required.

Performance Metrics

• File audit scores

• Customer satisfaction and responsiveness

• Claims management outcomes

• Timely and accurate indemnity payments

What We Offer

• Generous PTO: 4 weeks in your first year + 10 paid holidays

• Comprehensive Benefits: Medical, Dental, Vision, Life Insurance, 401(k), and ESOP (employee ownership)

• Professional Development: Robust training and advancement opportunities

• Work Environment: Remote flexibility with strong team collaboration and support

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.

 

CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits.

 

Visa Sponsorship:

CCMSI does not provide visa sponsorship for this position.

 

ADA Accommodations:

CCMSI is committed to providing reasonable accommodations throughout the applicat