Workers' Compensation Claim Consultant

Position Title Workers' Compensation Claim Consultant (WV, FL, GA, SC, NC, VA) Location Maitland, FL (Hybrid preferred, remote considered) Schedule 8:00 am-5:00 pm ET Salary Range $70,000-$90,000 Job Summary We are seeking an experienced 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. This full life‑cycle WC adjuster role offers a strong development pathway for advancement into more senior claim positions. Responsibilities 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, negotiating any disputed bills or invoices for resolution. Authorize and make payments of claims in accordance with claim procedures using a claim payment program in line with industry standards and within established payment authority. Negotiate settlements in accordance with 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 (e.g., legal, surveillance, case management). Assess and monitor subrogation claims for resolution. Review and maintain personal diary on claim system. Ensure client satisfaction. Prepare reports detailing claim status, payments and reserves, as requested. Compute disability rates in accordance with state laws. Coordinate effective 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. Maintain compliance with Corporate Claim Handling Standards and special client handling instructions. Required Qualifications Five or more years of Workers’ Compensation claims experience. Proficiency with Microsoft Office products, including Word, Excel, and Outlook. Adjuster’s license required (one or more): FL, GA, NC, SC, WV. Preferred Qualifications Bachelor’s degree is preferred but not required. Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required. Benefits 4 weeks paid time off 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: supportive, team‑based work environment. 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. 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