Workers Compensation Claims Examiner

Workers' Compensation Claim Consultant - Midwest National AccountLocation: Remote Schedule: Monday – Friday, 8:00 AM – 4:30 PM CT Salary Range: $75,000 - $85,000Build Your Career With Purpose at CCMSIAt 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 SummaryThe Workers' Compensation Claim Consultant is responsible for the investigation and adjustment of assigned workers' compensation claims across Midwest jurisdictions, including Kansas, Missouri, Illinois, Iowa, Nebraska, and Indiana, with a strong concentration in Illinois. This role manages claims from assignment through resolution (cradle to grave), including files with litigation exposure, while ensuring compliance with CCMSI claim handling standards, client-specific instructions, and applicable state laws.This position is ideal for experienced adjusters with 3+ years of workers' compensation claim handling experience who are comfortable managing multi-jurisdictional claims and delivering consistent, high-quality outcomes in a national account environment. The Claim Consultant is accountable for the quality of claim services as perceived by CCMSI clients and plays a key role in delivering responsive, accurate, and timely claim handling.This is a full life-cycle WC adjuster role within a TPA environment, requiring strong communication, follow-through, and the ability to manage a dynamic claim volume.ResponsibilitiesWhen 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.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.QualificationsRequired Qualifications3+ years of workers' compensation claim handling experienceStrong experience handling Illinois workers' compensation claimsExperience managing claims across multiple jurisdictionsExposure to or experience with litigated workers' compensation claimsStrong analytical, organizational, and decision-making skillsExcellent verbal and written communication skills with a high standard for responsivenessAbility to manage a full caseload independently in a fast-paced environmentProficiency in Microsoft Office applicationsReliable, predictable attendance during assigned client service hoursPreferred QualificationsIA and/or NE adjuster licenses are a plusPrior TPA experience handling national or multi-state accountsExperience with high-volume or complex claim environmentsBilingual (Spanish) proficiency—highly valued for communicating with claimants, employers, or vendors, but not required.Why You'll Love Working Here4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first yearComprehensive benefits: Medical, Dental, Vision, Life, and Disability InsuranceRetirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)Career growth: Internal training and advancement opportunitiesCulture: A supportive, team-based work environmentHow We Measure SuccessAt CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:Quality claim handling – thorough investigations, strong documentation, well-supported decisionsCompliance & audit performance – adherence to jurisdictional and client standardsTimeliness & accuracy – purposeful file movement and dependable executionClient partnership – proactive communication and strong follow-throughProfessional judgment – owning outcomes and solving problems with integrityCultural alignment – believing every claim represents a real person and acting accordinglyThis is where we shine, and we hire adjusters who want to shine with us.Compensation & ComplianceThe 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.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 ValuesAt 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.