Workers' Compensation Claim Adjuster (DE, DC, MD)

Overview Position Title: Workers’ Compensation Claim Adjuster (DE, DC, MD focus) Location: Hybrid (Reporting to Wall Township, NJ) Schedule: Monday – Friday | 8:00 AM – 4:30 PM EST Salary Range: $65,000 – $70,000 Reasons You Should Consider a Career With CCMSI Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner—with integrity, passion and enthusiasm. Career development: CCMSI offers robust internships and internal training programs for advancement within our organization. Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP. Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads. Job Summary The Workers' Compensation Claim Consultant (Adjuster) is responsible for the investigation and adjustment of assigned claims, focusing on DE, DC, and MD claims. This position may be used as an advanced training position for consideration of promotion to a more senior level claim position. Responsibilities Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations within established reserve authority levels. Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program within established payment authority. Negotiate settlements in accordance with Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Assess and monitor subrogation claims for resolution. Review and maintain personal diary on claim system. Client satisfaction. Prepare reports detailing claim status, payments and reserves, as requested. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process. Prepare newsletter articles, as requested. Provide notices of qualifying claims to excess/reinsurance carriers. Handle more complex and involved claims than lower level claim positions with minimum supervision. Conduct claim reviews and/or training sessions for designated clients, as requested. Attend and participate at hearings, mediations, and informal legal conferences, as appropriate. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Performs other duties as assigned. Qualifications Five or more years claims experience required. Bachelor degree preferred. Education and/or Experience Five or more years claims experience is required. Bachelor degree preferred. Computer Skills Proficient using Microsoft Office products such as Word, Excel, Outlook, etc. Certificates, Licenses, Registrations Adjuster’s license may be required based upon jurisdiction. Physical Demands Work requires the ability to stoop, bend, reach and grab with arms and hands, manual dexterity. Work requires the ability to sit or stand up to 7.5 or more hours at a time. Work requires sufficient auditory and visual acuity to interact with others. Core Values & Principles Responsible for upholding the CCMSI Core Values & Principles including: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example. Compensation & Compliance The 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 a comprehensive benefits package, which will be reviewed during the hiring process. Visa Sponsorship CCMSI does not provide visa sponsorship for this position. ADA Accommodations CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer CCMSI is an affirmative action / equal employment opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. #J-18808-Ljbffr