Workers Compensation Claim Consultant (PA, NJ, DE)

Overview

Position Title: Workers' Compensation Claim Adjuster (NJ, PA, DE) Location: Hybrid (Reporting to Linwood, NJ) Schedule: Monday

• Friday | 8:00 AM
• 4:30

PM EST Salary Range: $65,000

• $80,000 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. The Workers' Compensation Claim Consultant (Adjuster) is responsible for the investigation and adjustment of assigned claims. This adjuster will focus on New Jersey 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. (i.e. legal, surveillance, case management, etc.) 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.

Qualifications

Education and/or Experience Five or more years claims experience is required. Bachelor degree is preferred. Nice to Have: 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 At 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 accordingly This is where we shine, and we hire adjusters who want to shine with us.

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