Workers' Compensation Claim Representative II
2 weeks ago
Overview
At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile.
Reasons you should consider a career with CCMSI:
Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm. Career development: CCMSI offers robust internships and internal training programs for advancement within our organization. Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP. Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads.The Workers' Compensation Claim Representative II is responsible for the investigation and adjustment of assigned claims. This position may be used as an advanced training position for consideration of promotion to a more senior level claim position. Accountable for the quality of claim services as perceived by CCMSI clients and within our corporate claim standards.
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. 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. (. legal, surveillance, case management, 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. 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. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Performs other duties as assigned.
Qualifications
Education and/or Experience
Three or more years experience adjusting California Workers' Compensation Claims is required.
Computer Skills
Proficient using MicroSoft Office products such as Word, Excel, Outlook, etc.
Certificates, Licenses, Registrations
Adjuster's license is preferred. (California SIP)
CORE VALUES & PRINCIPLES
Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.
CCMSI is an Affirmative Action/Equal Employment Opportunity employer offering an excellent benefit package included Medical, Dental, Vision, Prescription Drug, Flexible Spending, Life, ESOP and 401K.
#CCMSI #EmployeeOwned #GreatPlaceToWorkCertified #SmallTeams #LowCaseLoad #WorkComp #AdjusterJobs #HiringNow #InsuranceCareers #IND1234
Need help finding the right job?
-
Irvine, United States CCMSI Full timeOverview: At **CCMSI**, **we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development...
-
Irvine, United States CCMSI Full timeOverview: At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs,...
-
Irvine, California, United States CCMSI Full timeOverview: At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs,...
-
Worker's Compensation Attorney
3 weeks ago
Irvine, United States Advantex Professional Services Full timeJob Title: In-House Workers' Compensation Attorney Location: Irvine, CA Job Type: Full-Time About Us: A reputable service company headquartered in Irvine, CA is deeply committed to cultivating a workplace that is safe, fair, and conducive to productivity. They prioritize the health and safety of their employees and are dedicated to handling all...
-
Worker's Compensation Attorney
2 days ago
Irvine, United States Advantex Professional Services Full timeJob Title: In-House Workers' Compensation AttorneyLocation: Irvine, CAJob Type: Full-TimeAbout Us: A reputable service company headquartered in Irvine, CA is deeply committed to cultivating a workplace that is safe, fair, and conducive to productivity. They prioritize the health and safety of their employees and are dedicated to handling all workers'...
-
Worker's Compensation Attorney
2 weeks ago
Irvine, United States Advantex Professional Services Full timeJob Title: In-House Workers' Compensation AttorneyLocation: Irvine, CAJob Type: Full-TimeAbout Us: A reputable service company headquartered in Irvine, CA is deeply committed to cultivating a workplace that is safe, fair, and conducive to productivity. They prioritize the health and safety of their employees and are dedicated to handling all workers'...
-
Worker's Compensation Attorney
2 weeks ago
Irvine, United States Advantex Professional Services Full timeJob Title: In-House Workers' Compensation AttorneyLocation: Irvine, CAJob Type: Full-TimeAbout Us: A reputable service company headquartered in Irvine, CA is deeply committed to cultivating a workplace that is safe, fair, and conducive to productivity. They prioritize the health and safety of their employees and are dedicated to handling all workers'...
-
Workers' Compensation Claim Adjuster
2 weeks ago
Irvine, United States CCMSI Full timeOverview: At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs,...
-
Workers' Compensation Claim Adjuster
3 weeks ago
Irvine, California, United States CCMSI Full timeOverview: At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs,...
-
Worker's Comp Claims Manager
7 days ago
Irvine, United States Emplicity Full timeJob Summary Emplicity is a Professional Employer Organization (PEO) and outsourced Human Resources and Business Services provider that helps organizations manage the delicate and daunting task of running a business while supervising employees. From payroll services and employer insurances to benefits plans and employee relations, Emplicitys tailored approach...
-
Workers' Compensation Legal Assistant I
3 weeks ago
Irvine, California, United States AmTrust Financial Services Full timeOverviewResponsible for supporting the California Workers' Compensation Hearing Representative Unit handling cases from the outset of lien litigation through trial. Responsibilities include the preparation of pleadings, coordination of schedules, communication with Claims, and organization of files. Maintains a solid understanding of AmTrust's mission,...
-
Workers' Compensation Legal Assistant I
4 weeks ago
Irvine, California, United States AmTrust Financial Services, Inc. Full timeOverview: Responsible for supporting the California Workers’ Compensation Hearing Representative Unit handling cases from the outset of lien litigation through trial. Responsibilities include the preparation of pleadings, coordination of schedules, communication with Claims, and organization of files. Maintains a solid understanding of AmTrust’s mission,...
-
Worker's Comp Administrator
1 month ago
Irvine, United States Emplicity Full timeJob DescriptionJob DescriptionJob SummaryEmplicity is a Professional Employer Organization (PEO) and outsourced Human Resources and Business Services provider that helps organizations manage the delicate and daunting task of running a business while supervising employees. From payroll services and employer insurances to benefits plans and employee relations,...
-
Claims Adjuster Iii, Ca
4 weeks ago
Irvine, United States AmTrust Financial Services, Inc. Full timeOverview: The Workers' Compensation Adjuster III is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. The Adjuster III is often, though not always, assigned to larger or more complex claims...
-
Senior Liability Claim Representative
1 week ago
Irvine, United States Western Mutual Insurance Company Full timeThe Western Mutual Insurance Group has been providing excellent customer service to homeowners throughout the Southwestern United States for over 80 years. We are rated A (Excellent) by A.M. Best Company and have been named among the Top 50 Property Casualty Insurers in the country by Wards. Our constant endeavor in employee relations is to maintain a...
-
Senior Liability Claim Representative
4 weeks ago
Irvine, United States Western Mutual Insurance Group Full timeThe Western Mutual Insurance Group has been providing excellent customer service to homeowners throughout the Southwestern United States for over 80 years. We are rated A (Excellent) by A.M. Best Company and have been named among the Top 50 Property Casualty Insurers in the country by Ward’s.Our constant endeavor in employee relations is to maintain a...
-
Senior Liability Claim Representative
4 weeks ago
Irvine, United States Western Mutual Insurance Group Full timeThe Western Mutual Insurance Group has been providing excellent customer service to homeowners throughout the Southwestern United States for over 80 years. We are rated A (Excellent) by A.M. Best Company and have been named among the Top 50 Property Casualty Insurers in the country by Ward’s.Our constant endeavor in employee relations is to maintain a...
-
Senior Liability Claim Representative
1 month ago
Irvine, United States Western Mutual Insurance Group Full timeThe Western Mutual Insurance Group has been providing excellent customer service to homeowners throughout the Southwestern United States for over 80 years. We are rated A (Excellent) by A.M. Best Company and have been named among the Top 50 Property Casualty Insurers in the country by Ward’s.Our constant endeavor in employee relations is to maintain a...
-
Claims Adjuster III, CA
4 weeks ago
Irvine, California, United States AmTrust Financial Services, Inc. Full timeOverview: The Workers' Compensation Adjuster III is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. The Adjuster III is often, though not always, assigned to larger or more complex claims...
-
Temp Claims Recovery Analyst
4 days ago
Irvine, United States The Phoenix Group Full timeClaims Recovery Analysts II are assigned to the Antitrust Practice Group and are expected to provide service and support to the Claims Recovery team on projects as assigned. Claims Recovery Analysts II are responsible for the gathering, scrubbing, ma Claims, Recovery, Analyst, Microsoft, Staffing, Technology
