Workers' Compensation Claim Representative II
$60,000–$72,000 year
HybridReno, Nevada, United States
Job Summary
Investigate and adjust workers compensation claims using CCMSI guidelines and direct supervision, reviewing medical, legal, and miscellaneous invoices to determine reasonableness and negotiate disputed bills. Authorize and make payments within settlement authority while negotiating settlements with claimants and attorneys per client authorization. Assist in defense attorney selection, monitor subrogation claims, and prepare reports detailing claims, payments, and reserves. Provide required reports to excess insurers and ensure compliance with team service commitments and jurisdictional standards. This role supports injured workers and strengthens client trust as a developmental step toward senior positions within CCMSI's largest privately owned Third Party Administrator.
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).
Desired 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.
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