Workers' Compensation Claim Representative II

Overview Workers' Compensation Claim Representative II Location: Reno, NV Schedule: 7:30am - 4:00pm (PST) - Hybrid schedule after initial training period. Compensation: $65,000 - $80,000 (depending on experience) Job Summary The Workers' Compensation Claim Representative I is responsible for the investigation and adjustment of assigned workers' compensation claims. This position may be used as an advanced training role for future consideration for promotion to a Work Comp Claim Representative II or more senior-level claim position. The Claim Representative I manages a reasonable caseload of indemnity claims of moderate to high complexity , with exposure to both non-litigated and litigated matters , including a moderate to heavy percentage of litigated claims. Assigned claims span multiple client accounts and are handled within the Nevada jurisdiction. This role is accountable for delivering quality claim services as perceived by CCMSI clients while adhering to corporate claim standards. Responsibilities 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 3+ years of Nevada Workers’ Compensation claims experience or related insurance industry experience. Strong organizational skills with the ability to prioritize and manage multiple tasks independently. Effective verbal and written communication skills for interaction with internal teams, clients, and external partners. Ability to work collaboratively in a fast-paced, changing environment while maintaining accuracy and confidentiality. Reliable and predictable attendance during established hours. Proficiency with Microsoft Office applications (Word, Excel, Outlook). Active adjuster license in Nevada or ability to obtain required licensing. Experience supporting multiple accounts, indemnity claims, and litigated Workers’ Compensation claims. Nice to Have Associate’s degree or higher, or related insurance industry experience. Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required. Why You’ll Love Working Here 4 weeks PTO + 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. 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. If you need assistance or accommodation, please contact our team. Equal Opportunity Employer CCMSI is an Affrimateive Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. #J-18808-Ljbffr