Claims Representative

Medical Only Claim RepresentativeLocation: Hybrid – Carson City, NV or Reno, NVSchedule: Monday–Friday, 8:00 AM–4:30 PM (37.5 hours/week)Salary Range: $22 to $25/hr (hourly position)Build Your Career With Purpose at CCMSIAt CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.We don't just process claims—we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work®, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.Job SummaryThe Medical Only Claim Representative manages a designated caseload of Nevada workers' compensation medical-only claims for a multi-account desk. This role focuses on accurate, timely, and compliant claim handling, ensuring strong documentation, customer service, and file progression.This position may support career development toward an intermediate-level adjusting role.This is a true workers' compensation adjuster position responsible for managing claims—not an HR or consulting role.ResponsibilitiesWe hire adjusters who take ownership, communicate with purpose, and move files with integrity and accuracy.Set up and manage Nevada medical-only workers' compensation claims in accordance with corporate claim standards and statutory requirements.Establish reserves and/or provide reserve recommendations within assigned authority levels under supervision.Review, approve, and negotiate medical and miscellaneous invoices related to assigned claims.Request, track, and monitor medical treatment to ensure timely and appropriate care.Maintain accurate and timely claim documentation, including detailed log notes and diary management.Summarize medical records and correspondence and ensure documentation is properly filed.Participate in claim reviews and collaborate with client service teams.Close claim files when appropriate and retrieve/return closed files to storage as needed.Maintain compliance with Nevada regulations, corporate Best Practices, and client-specific handling instructions.QualificationsWhat You'll Bring...RequiredNV Adjuster License (or the ability to obtain within 90 days of hire)Associate Degree or two (2) years of related business experienceStrong organizational skills and the ability to manage multiple tasks and deadlinesProficiency in Microsoft Office (Word, Excel, Outlook)Effective written and verbal communication skillsAbility to maintain accurate, timely documentation and purposeful file movementWhy You'll Love Working Here4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first yearComprehensive benefits : Medical, Dental, Vision, Life, and Disability InsuranceRetirement plans : 401(k) and Employee Stock Ownership Plan (ESOP)Career growth : Internal training and advancement opportunitiesCulture : A supportive, team-based work environmentHow We Measure SuccessAt CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:Quality claim handling – thorough investigations, strong documentation, well-supported decisionsCompliance & audit performance – adherence to jurisdictional and client standardsTimeliness & accuracy – purposeful file movement and dependable executionClient partnership – proactive communication and strong follow-throughProfessional judgment – owning outcomes and solving problems with integrityCultural alignment – believing every claim represents a real person and acting accordinglyThis is where we shine, and we hire adjusters who want to shine with us.Compensation & ComplianceThe 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 comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.Our Core ValuesAt CCMSI, we believe in doing what's right—for our clients, our coworkers, and ourselves. We look for team members who:Lead with transparency We build trust by being open and listening intently in every interaction.Perform with integrity We choose the right path, even when it is hard.Chase excellence We set the bar high and measure our success. What gets measured gets done.Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.Win together Our greatest victories come when our clients succeed.We don't just work together—we grow together. If that sounds like your kind of workplace, we'd love to meet you.#EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers#WorkersCompJobs #MedicalOnlyClaims #NevadaJobs #RenoJobs #CarsonCityJobs #ClaimsCareers #HybridJobs #IND456 #LI-Hybrid CCMSI