Workers' Compensation Claim Representative I

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    "title": "Workers' Compensation Claim Representative I",
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    "datePosted": "2026-05-19T04:00:00.000Z",
    "description": "<h2>Overview</h2>\n<p><strong>Work Comp Claim Rep I </strong></p>\n<p><strong>Location:</strong> Albuquerque, NM <strong>Schedule:</strong> 8:00am - 4:30 pm (MST)<strong>Compensation:</strong> $55,000- $60,000</p>\n<p> </p>\n<p><strong>Build Your Career With Purpose at CCMSI</strong></p>\n<p> </p>\n<p>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. </p>\n<p> </p>\n<p>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.</p>\n<p> </p>\n<p><strong>Job Summary</strong> </p>\n<p> </p>\n<p> </p>The \n<strong>Workers’ Compensation Claim Representative I</strong> handles the investigation and adjustment of assigned claims while ensuring high-quality service that meets CCMSI client expectations and company standards. This role also serves as a developmental position, preparing employees for advancement to higher-level claims roles. Experience handling \n<strong>education</strong> or \n<strong>educational services</strong> is preferred. \n<p> </p>\n<p> </p>\n<h2>Responsibilities</h2>\n<p>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.</p>\n<ul>\n <li>Investigate and adjust workers compensation claims in accordance with established claims handling procedures using CCMSI guidelines and direct supervision. </li>\n <li>Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing workers compensation claims. Negotiate any disputed bills for resolution. </li>\n <li>Authorize and make payment of workers compensation claims utilizing a claim payment program in accordance with industry standards and within settlement authority. </li>\n <li>Negotiate settlements with claimants and attorneys in accordance with client's authorization. </li>\n <li>Assist in selection and supervision of defense attorneys. </li>\n <li>Assess and monitor subrogation claims for resolution. </li>\n <li>Prepare reports detailing claims, payments and reserves. </li>\n <li>Provide reports and monitor files, as required by excess insurers. </li>\n <li>Compliance with Service Commitments as established by team. </li>\n <li>Delivery of quality claim service to clients.</li>\n</ul>\n<h2>Qualifications</h2>\n<h2><strong>What You’ll Bring</strong></h2>\n<h4><strong>Required</strong></h4>\n<ul>\n <li><p><strong>3+ years of New Mexico Workers’ Compensation claims experience</strong> or related insurance industry experience.</p></li>\n <li><p>Strong organizational skills with the ability to <strong>prioritize and manage multiple tasks</strong> independently.</p></li>\n <li><p>Effective verbal and written communication skills for interaction with internal teams, clients, and external partners.</p></li>\n <li><p>Ability to work collaboratively in a <strong>fast-paced, changing environment</strong> while maintaining accuracy and confidentiality.</p></li>\n <li><p>Reliable and predictable attendance during established hours.</p></li>\n <li><p>Proficiency with <strong>Microsoft Office</strong> applications (Word, Excel, Outlook).</p></li>\n <li><strong>Active adjuster license in New Mexico</strong> or ability to obtain required licensing for <strong>New Mexico</strong> within <strong>60 days</strong> of hire, if applicable.</li>\n <li>Experience supporting <strong>education</strong> or <strong>educational services</strong> Workers’ Compensation claims.</li>\n</ul>\n<h4><strong>Nice to Have</strong></h4>\n<ul>\n <li><p>Associate’s degree or higher, or related insurance industry experience.</p></li>\n <li><strong>Bilingual (Spanish) proficiency</strong> — highly valued for communicating with claimants, employers, or vendors, but not required.</li>\n</ul>\n<p> </p>\n<p><strong>Why You’ll Love Working Here</strong></p>\n<p> </p>\n<ul>\n <li><strong>4 weeks PTO + 10 paid holidays in your first year</strong></li>\n <li><strong>Comprehensive benefits</strong>: Medical, Dental, Vision, Life, and Disability Insurance</li>\n <li><strong>Retirement plans</strong>: 401(k) and Employee Stock Ownership Plan (ESOP)</li>\n <li><strong>Career growth</strong>: Internal training and advancement opportunities</li>\n <li><strong>Culture</strong>: A supportive, team-based work environment</li>\n</ul>\n<p><strong>How We Measure Success</strong> </p>\n<p> </p>\n<p>At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: </p>\n<p> </p>\n<ul>\n <li><strong>Quality claim handling</strong> – thorough investigations, strong documentation, well-supported decisions• <strong>Compliance & audit performance</strong> – adherence to jurisdictional and client standards• <strong>Timeliness & accuracy</strong> – purposeful file movement and dependable execution• <strong>Client partnership</strong> – proactive communication and strong follow-through• <strong>Professional judgment</strong> – owning outcomes and solving problems with integrity• <strong>Cultural alignment</strong> – believing every claim represents a real person and acting accordingly </li>\n</ul>\n<p><strong><em>This is where we shine, and we hire adjusters who want to shine with us.</em></strong></p>\n<p> </p>\n<p>Compensation & Compliance</p>\n<p>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.</p>\n<p> </p>\n<p>Visa Sponsorship:</p>\n<p>CCMSI does not provide visa sponsorship for this position.</p>\n<p> </p>\n<p>ADA Accommodations:</p>\n<p>CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team.</p>\n<p> </p>\n<p>Equal Opportunity Employer:</p>\n<p>CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment.</p>\n<p> </p>\n<p><strong>Our Core Values</strong></p>\n<p> </p>\n<p>At CCMSI, we believe in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who:</p>\n<p> </p>\n<ul>\n <li><strong>Lead with transparency </strong>We build trust by being open and listening intently in every interaction.</li>\n <li><strong>Perform with integrity </strong>We choose the right path, even when it is hard.</li>\n <li><strong>Chase excellence </strong>We set the bar high and measure our success. What gets measured gets done.</li>\n <li><strong>Own the outcome </strong>Every employee is an owner, treating every claim, every decision, and every result as our own.</li>\n <li><strong>Win together </strong>Our greatest victories come when our clients succeed.</li>\n</ul>\n<p> </p>\n<p><strong>We don’t just work together—we grow together. If that sounds like your kind of workplace, we’d love to meet you.</strong></p>\n<p> </p>\n<p>#CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #TPA #InsuranceCareers #NewMexicoJobs #AlbuquerqueJobs #ClaimsCareers #IND123 #LI- Hybrid</p>\n<p> </p>",
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