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CCMSI

TPA for workers' comp and self-insurance

Workers' Compensation Claim Supervisor

Claims AdjudicationPosted on Nov 5
Full-time

About the Job

Requirements

  • At least 10 years of California workers’ compensation claims handling experience, including full claim investigation, evaluation, and resolution.
  • At least 3 years of claims-handling supervisory experience.
  • Ability to lead and oversee adjusters in a fast-paced, compliance-driven environment while maintaining quality and service standards.
  • Strong understanding of California workers’ compensation regulations, claim practices, and compliance requirements.
  • Active California SIP, or ability to obtain one.
  • Working knowledge of entry- and mid-level workers’ compensation adjusting roles and workflows.
  • Reliable attendance during established client service hours for the Las Vegas, Nevada, or Irvine, California, branch office.

Responsibilities

  • Review, assign, and supervise claim activity for designated claims to ensure compliance with Corporate Claim Standards, client-specific handling instructions, and applicable laws.
  • Investigate, evaluate, and adjust assigned claims according to established claim-handling standards and laws.
  • Establish reserves and/or oversee reserves for designated claims within established reserve authority levels.
  • Oversee medical, legal, damage estimate, and miscellaneous invoices to determine whether they are reasonable and related to designated claims, and negotiate disputed bills or invoices for resolution.
  • Authorize and make claim payments according to claim procedures, using a claim payment program and established payment authority.
  • Negotiate settlements according to Corporate Claim Standards, client-specific handling instructions, and state laws, when appropriate.
  • Assist designated claim staff in selecting, referring, and supervising designated claim files sent to outside vendors, such as legal, surveillance, and case management vendors.
  • Direct the handling of designated litigated and complex claims.
  • Provide education and training and assist in developing claim staff.
  • Review and maintain a personal diary in the claim system.
  • Supervise all claim activity for specified accounts.
  • Comply with Corporate Claim Handling Standards and special client handling instructions.

Desired Qualifications

  • Bachelor’s degree or equivalent combination of education and experience.
  • Experience supporting PEO, temporary agency, and agriculture accounts.
  • AIC, CPCU, or ARM designation.
  • Spanish proficiency for communicating with claimants, employers, or vendors.

About the Company

CCMSI

TPA for workers' comp and self-insurance

CCMSI provides third-party administration services for workers' compensation and property/casualty self-insurance programs. It manages claims and offers risk management and cost-containment strategies for self-insured entities, including group self-insurance associations. The product works by acting as an administrator for a client’s self-insurance program: handling claims, administering payments, and implementing risk controls and cost-saving measures on a fee basis. CCMSI differentiates itself by focusing on the self-insurance niche and serving organizations that bear their own insurance risks, rather than selling traditional insurance policies. The company’s goal is to help clients reduce claim costs and manage their self-insurance programs more effectively.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Danville, IL
Founded
1978

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