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Workers' Compensation Claims Adjuster - TN, GA, NC & SC (Hybrid/Remote)

$60k - $85k

Ccmsi

Nashville, TN
  • Remote job

Workers' Compensation Claim Consultant Overview Location: Nashville, TN (Hybrid or Remote, depending on location) Schedule: Monday-Friday, 8:00am -4:30pm Salary Range: $60,000 - $85,000 annually Work Arrangement Options: Remote for qualified candidates Hybrid schedule available with approximately 2 days per week in the Nashville office 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 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 Summary The Workers' Compensation Claim Consultant is responsible for the investigation, evaluation, administration, and resolution of Workers' Compensation claims across multiple national account programs. This role manages claims from assignment through closure while ensuring compliance with applicable state regulations, client handling requirements, and CCMSI claim handling standards. The successful candidate will handle a caseload of approximately 85–125 claims with moderate complexity, including litigated files, and will work primarily within the Tennessee, Georgia, North Carolina, and South Carolina jurisdictions . This position is ideal for an experienced Workers' Compensation adjuster who can independently manage a full claim inventory, communicate effectively with injured workers and stakeholders, and consistently deliver quality claim outcomes. 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, 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 in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within 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. Qualifications Required Qualifications 5+ years of Workers' Compensation claims handling experience preferred Active Georgia Workers' Compensation Adjuster License required (or ability to obtain if applicable) Experience managing claims from investigation through resolution Experience handling indemnity claims Strong understanding of Workers' Compensation claim practices and regulations Experience establishing reserves and evaluating claim exposure Ability to independently manage a caseload of 85–125 claims Experience handling litigated claims Strong written and verbal communication skills Effective negotiation and problem-solving abilities Strong organizational, diary management, and time-management skills, Proficiency with Microsoft Office applications including Outlook, Word, and Excel Reliable attendance during established business hours Preferred Qualifications Experience handling Tennessee, Georgia, North Carolina, and South Carolina Workers' Compensation claims Prior TPA experience Experience supporting national account clients Multi-jurisdictional Workers' Compensation experience Professional designations such as: AIC CPCU ARM WCP 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. 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, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. Our Core Values At 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.

  • CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #TPA #WorkersCompensation #WorkersCompClaims #WorkersCompAdjuster #ClaimsExaminer #WorkersCompConsultant #NationalAccounts #GeorgiaWorkersComp #TennesseeWorkersComp #NorthCarolinaWorkersComp #SouthCarolinaWorkersComp #InsuranceCareers #RemoteJobs #HybridJobs #NashvilleJobs #HiringNow #IND123
  • J-18808-Ljbffr CCMSI

Vacancy posted 2 days ago
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