Workers' Compensation Claim Representative II

Overview Workers' Compensation Claim Representative II Location: Reno, NV - Hybrid schedule after initial training. Schedule: 7:30am - 4:00pm (PST) Salary Range: $60,000 - $72,000 (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 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 We are seeking an experienced and motivated Nevada Workers’ Compensation Claim Representative II to manage a diverse portfolio of claims with professionalism, empathy, and strong technical skill. With 5–10 years of experience, you’ll bring seasoned judgment to claim investigations, compensability decisions, and timely resolution strategies. This role provides an excellent opportunity to deepen your expertise and serves as a developmental step toward more senior claim positions. As a Claim Representative II, you’ll play a key role in delivering an exceptional client experience and upholding CCMSI’s high standards for quality claim service. 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 5+ years of Workers' Compensation claims management experience, or an equivalent combination of education and experience. Current Nevada Adjuster's License required. Strong organizational, prioritization, and multitasking skills with the ability to work independently. Excellent verbal and written communication skills. Ability to maintain confidentiality and exercise sound judgment. Proven ability to thrive in a fast‑paced, changing environment and work effectively as part of a team. Customer-focused with a commitment to responsive service. Proficiency in Microsoft Office Suite (Word, Excel, Outlook). Preferred Qualifications Associate degree is preferred but not required. Experience handling multiple accounts of various industries. 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 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 judgement – 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. 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 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.

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