Texas Work Comp Insurance Adjuster - Remote

Workers' Compensation Claim Representative II

Location: Dallas, TX reporting remotely Schedule: 8:00 am - 4:30 pm (CST) Salary Range: $68,000 - $78,000 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 Workers' Compensation Claim Representative II to manage a portfolio of Texas workers' compensation claims with professionalism, empathy, and sound decision-making. With 5+ years of claims experience, you'll investigate claims, make compensability decisions, and drive timely, effective resolutions.

This role handles moderately complex claims across multiple accounts and industries, making it a great fit for someone who enjoys variety and can easily adapt to different client needs. As part of our commitment to flexibility, you'll have the ability to work remotely from day one. You'll play a key role in delivering an exceptional client experience while continuing to grow your technical expertise and advance your claims career with CCMSI.

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

• Excellent oral and written communication skills.
• Self-starter with strong organizational skills and the ability to work with minimal supervision.
• Texas Adjusting License is Required
• Proven ability to coordinate, prioritize, and manage multiple responsibilities.
• Flexibility, initiative, and adaptability in a fast-paced, rapidly changing environment.
• Strong discretion and ability to maintain confidentiality.
• Ability to work effectively as part of a team.
• Reliable, predictable attendance within client service hours.
• Responsiveness to internal and external client needs.
• Ability to communicate clearly and professionally, both verbally and in writing.
• 5 + of Texas Workers' Compensation claims management experience or equivalent combination of experience and education.
• Proficiency with Microsoft Office programs (Word, Excel, Outlook, etc.).

Preferred Qualifications

• Associate degree is preferred but not required.
• Bilingual (Spanish) proficiencyhighly 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 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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