Workers' Compensation Claim Representative II

Workers' Compensation Claim Representative II

Location: Reno, NV - Hybrid schedule after initial training. Schedule: 7:30am - 4:00pm (PST) Salary Range: $60,000 - $72,000 (depending on experience)

Build Your Career With Purpose at CCMSI

At 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 claimswe 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 Summary

We are seeking an experienced and motivated Nevada Workers' Compensation Claim Representative II to manage a diverse portfolio of claims with professionalism, empathy, and strong technical skill. With 510 years of experience, you'll bring seasoned judgment to claim investigations, compensability decisions, and timely resolution strategies. This role provides an excellent opportunity to deepen your expertise and serves as a developmental step toward more senior claim positions. As a Claim Representative II, you'll play a key role in delivering an exceptional client experience and upholding CCMSI's high standards for quality claim service.

Responsibilities

When we hire Workers' Compensation Adjusters at CCMSI, we look for detail-driven problem-solvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust.

• Investigate and adjust workers compensation claims in accordance with established claims handling procedures using CCMSI guidelines and direct supervision.
• Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing workers compensation claims. Negotiate any disputed bills for resolution.
• Authorize and make payment of workers compensation claims utilizing a claim payment program in accordance with industry standards and within settlement authority.
• Negotiate settlements with claimants and attorneys in accordance with client's authorization.
• Assist in selection and supervision of 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.
• Compliance with Service Commitments as established by team.
• Delivery of quality claim service to clients.

Qualifications

Required Qualifications

• 5+ years of Workers' Compensation claims management experience, or an equivalent combination of education and experience.

• Current Nevada Adjuster's License required.
• Strong organizational, prioritization, and multitasking skills with the ability to work independently.
• Excellent verbal and written communication skills.
• Ability to maintain confidentiality and exercise sound judgment.
• Proven ability to thrive in a fast-paced, changing environment and work effectively as part of a team.
• Customer-focused with a commitment to responsive service.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).

Preferred Qualifications

• Associate degree is preferred but not required.
• Experience handling multiple accounts of various industries.
• Bilingual (Spanish) proficiency highly valued for communicating with claimants, employers, or vendors, but not required.

Why You'll Love Working Here

• 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
• Comprehensive benefits : Medical, Dental, Vision, Life, and Disability Insurance
• Retirement plans : 401(k) and Employee Stock Ownership Plan (ESOP)
• Career growth : Internal training and advancement opportunities
• Culture : A supportive, team-based work environment

How We Measure Success

At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:

• Quality claim handling thorough investigations, strong documentation, well-supported decisions
• Compliance & audit performance adherence to jurisdictional and client standards
• Timeliness & accuracy purposeful file movement and dependable execution
• Client partnership proactive communication and strong follow-through
• Professional judgment owning outcomes and solving problems with integrity
• Cultural alignment believing every claim represents a real person and acting accordingly

This is where we shine, and we hire adjusters who want to shine with us.

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 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.

Our Core Values

At CCMSI, we believe in doing what's rightfor 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 togetherwe grow together. If that sounds like your kind of workplace, we'd love to meet you.

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