Workers Compensation Risk Management Jobs in Pennsylvania

OverviewWorkers' Compensation Claim Adjuster (New York)

Location: RemoteSchedule: 8:00 am-4:30 pm ETSalary Range: $70,000-$90,000+ depending on experience

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.

Why Experienced New York Adjusters Choose CCMSI

This is not a high-volume, multi-jurisdiction desk.

This role offers the opportunity to focus exclusively on New York Workers' Compensation claims within a dedicated client account supported by a highly collaborative team. You'll work alongside experienced professionals who value partnership, problem-solving, and quality claim handling over production quotas.

If you're looking for an environment where you can leverage your expertise, build client relationships, and manage claims strategically without constantly switching between jurisdictions, this may be the opportunity you're seeking.

What You Can Expect

• 100% focus on New York Workers' Compensation claims
• Dedicated client account
• Remote work flexibility
• Collaborative team environment with experienced claim professionals
• Opportunity to manage claims proactively and strategically
• Strong client relationships and partnership approach
• Employee-owned culture where your contributions matter
• Career growth opportunities within one of the nation's leading TPAs

Job Summary

We are seeking an experienced Workers' Compensation Claim Consultant with a strong New York claims background to manage a complex caseload from inception through resolution.

The ideal candidate brings at least five years of Workers' Compensation claims experience, possesses strong knowledge of New York Workers' Compensation laws and regulations, and thrives in a client-focused environment where quality claim outcomes, communication, and sound judgment are highly valued.

This position handles complex lost-time claims, develops claim strategies, collaborates with clients and vendors, and drives timely, cost-effective claim resolution while supporting injured workers throughout the claim lifecycle.

Responsibilities

When 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 Workers' Compensation claims in accordance with New York Workers' Compensation laws, regulations, and CCMSI claim handling standards.

• Develop and execute strategic action plans for complex claims.

• Establish and manage reserves within established authority levels.

• Authorize and approve payments in accordance with claim handling procedures and authority guidelines.

• Evaluate medical, legal, vocational, and miscellaneous expenses for appropriateness and claim relevance.

• Coordinate and oversee defense counsel, nurse case management, IMEs, surveillance, and other vendors as appropriate.

• Negotiate settlements in accordance with client instructions, corporate standards, and applicable state regulations.

• Identify and pursue subrogation and recovery opportunities.

• Maintain proactive diary management and timely claim documentation.

• Prepare claim status reports, reserve analyses, and client communications.

• Compute disability benefits in accordance with New York Workers' Compensation requirements.

• Communicate effectively with clients, injured workers, employers, medical providers, attorneys, and other claim stakeholders.

• Participate in hearings, mediations, settlement conferences, and other claim-related proceedings as appropriate.

• Deliver exceptional client service while maintaining compliance with corporate claim handling standards and client-specific requirements.

Qualifications

Required Qualifications

 

• Minimum of five years of Workers' Compensation claims adjusting experience.

• Active New York Workers' Compensation Adjuster's License.

• Demonstrated experience handling New York lost-time and complex Workers' Compensation claims.

• Strong working knowledge of New York Workers' Compensation statutes, regulations, and claim procedures.

• Excellent investigation, negotiation, and analytical skills.

• Ability to independently manage a full claim caseload and drive claims to resolution.

• Proficiency with Microsoft Office products, including Word, Excel, and Outlook. 

Preferred Qualifications

• Prior TPA experience.

• Experience handling litigated New York Workers' Compensation claims.

• Bilingual (Spanish) proficiency-highly valued for communicating with claimants, employers, providers, and vendors but this is 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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Employment Type: OTHER