Insurance Claim Review Jobs in California (NOW HIRING)

OverviewWorkers' Compensation Claims Adjuster - California - RemoteLocation: Remote (California Residents Preferred)

Schedule: 8 am - 4:30pm PSTSalary Range: $92,000 annually 

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

The Senior Workers' Compensation Claims Adjuster is responsible for the investigation, evaluation, administration, and resolution of California Workers' Compensation claims across multiple client programs.

This role manages claims from assignment through closure while ensuring compliance with California workers' compensation laws, client-specific handling instructions, and CCMSI claim handling standards.

The ideal candidate is an experienced California adjuster who understands how to manage an active inventory, navigate litigated files, make sound claim decisions, and communicate confidently with injured workers, attorneys, employers, medical providers, and clients.

Most importantly, we're looking for someone who thrives in a culture built on accountability, collaboration, and trust. Our best adjusters are self-starters who take ownership of their files, communicate proactively, and consistently deliver high-quality claim outcomes.

ResponsibilitiesWhen we hire Workers' Compensation Adjusters at CCMSI, we look for detaildriven problemsolvers 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, evaluate, and adjust California Workers' Compensation claims from assignment through resolution

• Manage indemnity and medical exposures while developing effective claim strategies

• Handle litigated claims and collaborate with defense counsel throughout the litigation process

• Determine compensability and establish appropriate reserves

• Coordinate medical treatment, return-to-work efforts, and vocational considerations when applicable

• Monitor claim activity and ensure timely file movement and diary management

• Evaluate settlement opportunities and negotiate claim resolutions within authority

• Communicate regularly with injured workers, employers, attorneys, medical providers, and clients

• Maintain accurate file documentation and claim reporting

• Participate in claim reviews and client meetings as requested

• Ensure compliance with California Workers' Compensation regulations and client handling requirements

QualificationsRequired Qualifications

• California Workers' Compensation claims handling experience
• Self-Insured Administrator Certificate (SIP) required
• Strong understanding of California Workers' Compensation laws and regulations
• Experience handling litigated Workers' Compensation claims
• Experience managing claims from investigation through resolution
• Ability to independently manage a full caseload
• Strong reserve management and claim strategy skills
• Excellent verbal and written communication skills
• Strong negotiation and problem-solving abilities
• Ability to work independently in a remote environment
• Proficiency with Microsoft Office applications
• Reliable attendance during established business hours

Preferred Qualifications

• Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required.
• Prior TPA experience is helpful
• Experience presenting files during client claim reviews is helpful
• Multi-client account experience
• Professional designations such as AIC, ARM, or CPCU are preferred 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 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

At 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.

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