CA Workers' Comp Lien & Medical Management Adjuster - ...

Workers’ Compensation Claim Representative I - Remote (CA Jurisdiction, Future Medical / Lien Specialist)Location: Remote (reporting to Irvine, CA Branch)Schedule: Monday-Friday, 8:00 AM-4:30 PM PSTSalary Range: $60,000-$75,000 annuallyReports To: Workers’ Compensation SupervisorAccounts: Multiple accounts within the staffing and transportation industriesBuild Your Career With Purpose at CCMSIAt 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 SummaryWe are seeking an experienced Workers’ Compensation Claim Representative I to handle California jurisdiction claims with a focus on lien resolution and lifetime medical management. This remote position supports multiple accounts within the staffing and transportation industries and requires an individual who can manage complex medical issues, negotiate lien settlements, and maintain strong compliance with state and client requirements.This role is ideal for someone who enjoys analytical problem-solving, communicating with medical providers and attorneys, and driving claims toward fair and timely resolution.Important - Please Read Before ApplyingThis is a true insurance claims adjusting role, not an HR, benefits, safety, consulting, or administrative position. Candidates must have direct experience investigating, evaluating, reserving, negotiating, and resolving claims as an adjuster or adjuster supervisor within a carrier, TPA, or similar claims environment. When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person’s livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems.Investigate, evaluate, and adjust workers’ compensation claims in accordance with established procedures and California regulations.Negotiate and settle liens with lien claimants, medical providers, and applicant attorneys.Handle future medical/lifetime medical claims, ensuring timely authorization and payment of treatment, services, and prescriptions.Review medical reports, legal correspondence, and billing to determine reasonableness and relatedness to ongoing claims.Coordinate with defense counsel and vendors to resolve complex lien disputes.Maintain current and accurate diary, documentation, and billing records.Ensure compliance with CCMSI standards, client requirements, and jurisdictional timeframes.Deliver exceptional customer service to clients, claimants, and internal partners.Required:Minimum 2years of workers’ compensation claim handling experience, with exposure to lien resolution and/or lifetime medical management.SIP certification or Experienced Adjuster designation.Excellent written and verbal communication skills.Strong time management and organizational abilities with attention to detail.Proficiency in Microsoft Office programs (Word, Excel, Outlook).Preferred:Prior experience managing claims within the staffing or transportation industries.Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.Why You’ll Love Working Here4 weeks PTO + 10 paid holidays in your first yearComprehensive benefits: Medical, Dental, Vision, Life, and Disability InsuranceRetirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)Career growth: Internal training and advancement opportunitiesCulture: A supportive, team-based work environmentHow We Measure SuccessAt CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: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 accordinglyThis is where we shine, and we hire adjusters who want to shine with us.Compensation & ComplianceThe 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.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.Our Core ValuesAt CCMSI, we believe in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who: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.#NowHiring #WorkersCompensation #ClaimsAdjuster #LienResolution #RemoteJobs #InsuranceCareers #CaliforniaClaims #CareerGrowth #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #LI-Remote #WorkersComp #WorkersCompensationJobs #WCAdjuster #ClaimsJobs #AdjusterJobs #InsuranceJobs #RemoteAdjuster #CaliforniaJobs #CaliforniaAdjusters #InsuranceProfessionals #RiskManagementJobs #LegalSupportJobs #TPACareers #ClaimsHandling #LienSpecialist #FutureMedicalClaims #RemoteWork #HiringNow #RemoteCareers #JobSearch #IND123 #LI-Remote

Created: 2026-02-04