Why Files Jobs in Nevada (NOW HIRING)

OverviewClaim Representative, Medical Only Location: Carson City, NVSchedule: 8:00am - 4:30 pm (PST)Salary Range: $48,000 - $54,000 (depending on experience)Build 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 Summary 

The Medical Only Claim Representative is responsible for claims handling of designated medical only claims and provide support to claim staff.  This position may be used as a training position for consideration of promotion to an intermediate level claim position.  Is accountable for the quality of claim services as perceived by CCMSI clients and within the corporate claim standards.

ResponsibilitiesWhen we hire claim reps at CCMSI, we look for detail oriented professionals who understand that every task supports a real person's claim experience, value accuracy and responsiveness, and contribute to the team's success through organization, collaboration, and a strong commitment to service. Set up and manage medicalonly claim files in accordance with corporate claim standards and applicable laws  Establish reserves and provide reserve recommendations within authorized levels under direct supervision  Review and approve medical and miscellaneous invoices on designated claims; negotiate disputed bills or invoices under supervision  Request and monitor medical treatment in accordance with corporate claim handling standards  Summarize correspondence and medical records in claim system notes and file documentation appropriately  Close claim files when appropriate and retrieve closed files for refiling as requested  Provide ongoing support to claim staff on client service teams  Communicate with medical providers, injured workers, and internal partners; frequent phone work is required  Ensure compliance with corporate claim handling standards and special client handling instructions QualificationsRequired:   Associate Degree or two (2) years of related business experience  Customerservice oriented mindset with comfort communicating by phone  Strong organizational skills and ability to multitask effectively  Ability to work efficiently on a computer and manage detailed documentation  Proficiency with Microsoft Office applications including Word, Excel, and Outlook  Reliable, predictable attendance during assigned business hours  Nice to Have:   Knowledge of medical terminology  Prior experience in claims, insurance, or medical administrative support  Experience supporting a single client or program environment  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 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 accordingly  This 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. 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 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.#CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #InsuranceCareers #TPA #RenoJobs #NevadaJobs # #MedicalOnlyClaims #LI-Onsite #IND456Employment Type: OTHER