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CCMSI

TPA for workers' comp and self-insurance

Workers' Compensation Claim Adjuster - Nevada Claims

Claims AdjudicationPosted on Nov 5
Full-timeLas Vegas, NV, USA$65k - $85kIn-person

About the Job

Requirements

  • At least 5 years of Nevada workers' compensation claims experience.
  • Hold a Nevada adjuster's license or be able to obtain one.
  • Be proficient with Microsoft Office products, including Word, Excel, and Outlook.
  • Have oral and written communication, negotiation, and interpersonal skills.
  • Have analytical, organizational, and problem-solving abilities, with attention to detail.
  • Be able to set and achieve performance goals, prioritize and coordinate multiple responsibilities in a fast-paced environment, and work independently with minimal supervision.
  • Know lower-level workers' compensation claims functions and responsibilities.
  • Be able to maintain confidentiality and exercise sound professional judgment.
  • Maintain reliable, predictable attendance during client service hours.

Responsibilities

  • Investigate, evaluate, and adjust claims in accordance with claim handling standards and applicable laws.
  • Establish reserves and provide reserve recommendations within assigned authority levels.
  • Review and approve medical, legal, damage estimate, and miscellaneous invoices, and negotiate disputed charges when necessary.
  • Authorize and issue claim payments in accordance with established procedures, industry standards, and payment authority.
  • Negotiate claim settlements in compliance with Corporate Claim Standards, client-specific instructions, and state laws.
  • Select, refer, and oversee claim files assigned to outside vendors, including legal counsel, surveillance, and case management services.
  • Evaluate and monitor subrogation opportunities through resolution.
  • Maintain timely and accurate claim diaries and documentation.
  • Promote and maintain a high level of client satisfaction.
  • Prepare claim status, payment, and reserve reports as requested.
  • Calculate disability rates in accordance with state regulations.
  • Communicate with clients, claimants, and other involved parties throughout the claims process in a timely and effective manner.
  • Prepare newsletter articles and client communications as requested.
  • Provide required notifications to excess and reinsurance carriers.
  • Handle complex claims with minimal supervision.
  • Conduct claim reviews and training sessions for clients as requested.
  • Represent claims at hearings, mediations, and informal legal conferences as appropriate.
  • Maintain compliance with Corporate Claim Handling Standards and client-specific handling requirements.

Desired Qualifications

  • A bachelor's degree is preferred but not required.
  • Bilingual Spanish proficiency is valued for communicating with claimants, employers, or vendors, but is not required.
  • Experience handling municipal accounts is a plus.

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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