Full-Time

Workers' Compensation Claim Adjuster

North Carolina, South Carolina

Updated on 8/1/2026

Deadline 7/24/27
CCMSI

CCMSI

1,001-5,000 employees

TPA for workers' comp and self-insurance

Compensation Overview

$70k - $90k/yr

+ Bonus + Additional pay

No H1B Sponsorship

Maitland, FL, USA

Hybrid

Hybrid preferred; remote considered. Must work Eastern Time hours.

Category
Finance & Banking (1)
Required Skills
Microsoft Office
Word/Pages/Docs
Excel/Numbers/Sheets
Microsoft Outlook

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Requirements
  • Five or more years of Workers’ Compensation claims experience.
  • Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
  • An adjuster’s license and experience in one or more of North Carolina and South Carolina are required.
  • The role requires handling full life-cycle Workers’ Compensation claims in a third-party administrator environment.
  • The position requires compliance with corporate claim handling standards, client-specific handling instructions, applicable state laws, and jurisdictional requirements.
  • The position requires working Eastern Time hours from 8:00 am to 5:00 pm.
  • CCMSI does not provide visa sponsorship for this position.
Responsibilities
  • Investigate, evaluate, and adjust claims in accordance with established claim handling standards and laws.
  • Establish reserves or provide reserve recommendations within established reserve authority levels.
  • Review, approve, or provide oversight of 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 in accordance with claim procedures, industry standards, and established payment authority using a claim payment program.
  • Negotiate settlements in accordance with corporate claim standards, client-specific handling instructions, and state laws when appropriate.
  • Assist in the selection and referral of designated claim files to outside vendors, and supervise those vendors when assigned, including legal, surveillance, and case-management vendors.
  • Assess and monitor subrogation claims through resolution.
  • Review and maintain a personal diary in the claim system.
  • Support client satisfaction through effective claim handling and communication.
  • Prepare reports detailing claim status, payments, and reserves as requested.
  • Compute disability rates in accordance with state laws.
  • Coordinate timely communication with clients, claimants, and appropriate parties throughout the claim adjustment process.
  • Prepare newsletter articles as requested.
  • Provide notices of qualifying claims to excess and reinsurance carriers.
  • Handle more complex and involved claims than lower-level claim positions with minimal supervision.
  • Conduct claim reviews or training sessions for designated clients as requested.
  • Attend and participate in hearings, mediations, and informal legal conferences as appropriate.
  • Provide thorough investigations, strong documentation, and well-supported claim decisions.
  • Maintain compliance with jurisdictional and client standards.
  • Ensure timely and accurate file movement and claim execution.
  • Maintain proactive communication and follow-through with clients.
  • Own claim outcomes and resolve issues using professional judgment.
Desired Qualifications
  • A bachelor’s degree is preferred but not required.
  • Bilingual Spanish proficiency is highly valued for communicating with claimants, employers, or vendors.

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

N/A

Total Funding

N/A

Headquarters

Danville, Illinois

Founded

1978

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Simplify Jobs

Simplify's Take

What believers are saying

  • Self-insurance market growing as companies seek cost control alternatives.
  • AI capabilities enable competitive pricing and faster claims resolution.
  • Deep claims expertise and regional presence create switching costs.

What critics are saying

  • Larger TPAs like Sedgwick undercut pricing through superior scale.
  • State mandates for AI triage tools by 2027 require heavy investment.
  • Insurtech disruptors integrate blockchain, threatening legacy iCE system obsolescence.

What makes CCMSI unique

  • Largest independent TPA in US with 1,400+ employees across 41 offices.
  • AI-powered claims triage saved clients $300 million in workers' compensation costs.
  • 100% employee-owned firm prioritizes client-focused decisions over shareholder returns.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Health Savings Account/Flexible Spending Account

Unlimited Paid Time Off

Paid Holidays

401(k) Company Match

Company Equity