Workers’ Compensation Claim Consultant, Senior

Overview

Position Title: Workers’ Compensation Claim Specialist – Spanish BilingualLocation: Remote Work Arrangement: Fully RemoteSchedule: Monday–Friday, 8:00 AM to 4:30 PM PSTSalary Range: $90,000–$105,000 annuallyLicense/Certification Required: SIP designation or CA Designation of Workers' Compensation Adjuster requiredTravel Requirements: Yes – 2x per year for file reviews (3–4 days each)

Build Your Career with Purpose

At CCMSI, we believe our strength comes from our people. As an employee-owned company, we are driven by a shared commitment to service, integrity, and continuous improvement. You’ll have the chance to make a meaningful impact—not just in the claims you handle, but in the culture you help shape. If you're looking for a role where you can grow your career and truly make a difference, CCMSI is the place for you.

 

Job Summary

Join CCMSI as a Workers’ Compensation Claim Specialist, where you’ll handle a complex desk of California jurisdiction claims for multiple client accounts. This fully remote position requires fluency in Spanish and English, and a deep understanding of California workers’ compensation law. You’ll work independently, yet collaboratively, to deliver exceptional service, maintain quality standards, and ensure accurate, timely claim resolution.

Responsibilities

• Independently manage a full inventory of California workers’ compensation claims in accordance with state law, corporate claim handling procedures, and client-specific requirements

• Investigate, evaluate, negotiate, and settle claims, ensuring proper documentation and file integrity

• Approve or oversee the review of medical bills, legal fees, and other claim-related expenses

• Establish and maintain reserves within designated authority limits

• Make claim payments within authorization limits using appropriate claim systems

• Attend mediations, hearings, and two annual client file reviews (requires limited travel)

• Coordinate with outside vendors (legal, surveillance, case management) as needed

• Maintain consistent and professional communication with clients, claimants, and team members

• Monitor and pursue subrogation opportunities

• Train or mentor peers as needed; participate in special projects

• Ensure compliance with diary management, documentation expectations, and audit guidelines

Qualifications

Required:

• Minimum of 5 years of experience handling California workers’ compensation claims

• Fluent in both Spanish and English (written and verbal)

• Strong understanding of California WC law and regulations

• Ability to work independently in a remote setting

• Excellent organizational, negotiation, and communication skills

• Reliable attendance and adherence to client service hours (PST)

Nice to Have:

• Bachelor’s degree

• AIC designation

• Previous experience with multiple client accounts or TPA environments

Performance Metrics

• Diary and documentation compliance

• Internal and client audit scores

• Accuracy of reserve and payment recommendations

• Client communication and satisfaction

• Timely claim resolution and closure rates

What We Offer

• Four weeks of paid time off in your first year, plus 10 paid holidays

• Comprehensive benefits: Medical, Dental, Vision, Life Insurance, Critical Illness, Short & Long-Term Disability

• Employer-funded ESOP and 401K plan with company match

• Training, development programs, and advancement opportunities

• A collaborative, employee-owned work culture that prioritizes service and integrity

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:

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