Workers' Compensation Claim Specialist

Overview Workers' Compensation Claim Specialist Location: Albuquerque, NM Schedule: 8:00 am - 4:30 pm (MST). Hybrid schedule after training: 2 days in office, 3 days working from home. Salary Range: $70,000 - $85,000 (depending on experience) Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve complex risk management challenges and deliver measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to client success. As the largest privately owned Third Party Administrator, CCMSI delivers customized claim solutions that help our clients protect 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 seek a driven and compassionate Workers’ Compensation Claim Specialist with experience handling New Mexico Workers’ Compensation claims. In this role, you will take ownership of a dedicated portfolio of claims—leading investigations, determining compensability, and guiding each case toward a fair and timely resolution. The position requires experience managing litigated claims and working closely with legal counsel, preparing cases for hearings or trial, and participating in key legal proceedings. A strong understanding of workers’ compensation litigation and legal processes is essential for success. This role also offers opportunities to grow technical expertise and serve as an advanced development path for future supervisory or management roles. Responsibilities Investigate, evaluate, and adjust claims in accordance with established claim handling standards and laws. Establish reserves or provide reserve recommendations within established reserve authority levels. Maintain excellent documentation, organization, and communication skills, particularly in legal or quasi-legal environments. Review, approve, or provide oversight of medical, legal, damage estimates, and miscellaneous invoices to determine reasonableness and relevance to the claims. Negotiate disputed bills or invoices for resolution. Authorize and make payments of claims in accordance with claim procedures and payment authority using a claim payment program. Negotiate settlements in accordance with Corporate Claim Standards, client-specific handling instructions, and state laws when appropriate. Assist in selection, referral, and supervision of claim files sent to outside vendors (e.g., legal, surveillance, case management). Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Coordinate communication with clients, claimants, and other parties throughout the claim adjustment process. Provide notices of qualifying claims to excess/reinsurance carriers. Ensure compliance with Corporate Claim Handling Standards and special client handling instructions. Qualifications Required: 8+ years of Workers’ Compensation claims handling experience , including full claim investigation, evaluation, and resolution. Experience working directly with defense counsel on case strategy and legal proceedings. Strong knowledge of workers’ compensation laws and regulatory requirements (New Mexico preferred). Demonstrated understanding of legal processes and claim litigation, including hearings and trial preparation. Responsiveness to internal and external client needs. Strong analytical and negotiation abilities. Knowledge of all lower-level claim position responsibilities. New Mexico Adjuster license is required. Nice to Have: Bilingual (Spanish) proficiency —highly valued for communicating with claimants, employers, or vendors, but not required. Bachelor’s degree preferred but not required. Professional designations such as AIC, ARM, or CPCU preferred but not required. Why You’ll Love Working Here 4 weeks Paid Time Off that accrues throughout the year in accordance with company policy plus 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. 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. 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 complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background Checks Background checks, if required, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. #J-18808-Ljbffr Cannon Cochran Management Services, Inc.