Workers Compensation Claims Examiner

Overview Workers' Compensation Claim Adjuster (TX jurisdiction) Location: Dallas, TX Schedule: Hybrid – after initial training Salary Range: $65,000 – $80,000 Job Summary We are seeking an experienced and highly skilled Workers’ Compensation Claim Consultant to manage a complex portfolio of claims with confidence, empathy, and sound professional judgment. With 5+ years of hands‑on claims experience, you will lead thorough investigations, guide claim strategy, and ensure fair, timely resolutions. The Workers’ Compensation Claim Consultant is responsible for the investigation, evaluation, and adjustment of assigned workers’ compensation claims within the state of Texas, managing claims across a multiple account desk and ensuring compliance with Texas jurisdictional requirements. As a Claim Consultant, you will play a key role in delivering exceptional service to CCMSI clients, upholding our high standards of quality and responsiveness, and positioning yourself for advancement into more senior claim roles. This is a full life‑cycle WC adjuster position within a TPA environment, and only candidates with proven Workers’ Compensation claims experience will be considered. Responsibilities Investigate and adjust Texas workers’ compensation claims in accordance with CCMSI claim handling standards and state regulatory guidelines Manage claims from intake through resolution, including compensability determination, benefit administration, and claim closure Maintain a multiple account desk, balancing varying client expectations and service commitments Evaluate medical treatment plans and coordinate with providers to ensure appropriate care and cost containment Establish and manage reserves in accordance with claim exposure and corporate guidelines Communicate regularly with injured employees, employers, attorneys, and medical providers Identify and pursue subrogation opportunities where applicable Prepare detailed reports on claim status, payments, and reserve activity Ensure timely statutory filings and compliance with Texas workers’ compensation regulations Maintain accurate documentation, diary management, and adherence to service standards Deliver consistent, high‑quality service to internal and external clients Qualifications Required Qualifications Active Texas Workers’ Compensation Adjuster License 5+ years of experience handling Texas workers’ compensation claims end‑to‑end Strong knowledge of Texas jurisdictional requirements and regulatory compliance Excellent customer service, time management, and organizational skills Strong written and verbal communication skills Ability to prioritize and manage multiple claims across accounts Ability to work independently with minimal direct supervision Proficiency with Microsoft Office applications Nice to Have Bilingual (Spanish) proficiency is highly desired Experience working in a Third Party Administrator (TPA) environment is helpful Experience managing multiple account desks Benefits 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 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 for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. Our Core Values 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. #J-18808-Ljbffr