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CCMSI

TPA for workers' comp and self-insurance

Workers' Compensation Claims Adjuster 1

Claims AdjudicationUpdated on Nov 5
Full-timeSt. Louis, MO, USA$55k - $70k /yr

About the Job

Requirements

  • At least 2 years of workers’ compensation claims experience or related insurance industry experience.
  • Working knowledge of workers’ compensation claim-handling practices and claim life cycle management.
  • Ability to independently manage a full caseload of moderate-complexity claims.
  • Proficiency with Microsoft Office applications, including Outlook, Word, and Excel.
  • Experience handling Missouri workers’ compensation claims.
  • Strong verbal and written communication skills.
  • Organizational skills to prioritize multiple responsibilities.
  • Ability to work effectively in a collaborative, client-focused environment.
  • Reliable and predictable attendance during established business hours.

Responsibilities

  • Investigate and adjust workers’ compensation claims in accordance with established claims-handling procedures, CCMSI guidelines, and direct supervision.
  • Review medical, legal, and miscellaneous invoices to determine whether they are reasonable and related to ongoing workers’ compensation claims, and negotiate disputed bills for resolution.
  • Authorize and make payments on workers’ compensation claims using a claim payment program, in accordance with industry standards and within settlement authority.
  • Negotiate settlements with claimants and attorneys in accordance with client authorization.
  • Assist in selecting and supervising defense attorneys.
  • Assess and monitor subrogation claims for resolution.
  • Prepare reports detailing claims, payments, and reserves.
  • Provide reports and monitor files as required by excess insurers.
  • Comply with team-established service commitments.
  • Deliver quality claim service to clients.

Desired Qualifications

  • An associate’s degree or higher, or related insurance industry experience.
  • Bilingual Spanish proficiency for communicating with claimants, employers, or vendors.
  • Experience handling Illinois workers’ compensation claims.
  • Experience working within a third-party administrator, carrier, or self-insured claims environment.

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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