CA Workers' Comp Lien & Medical Management Adjuster - Remote (Rep I)

OverviewWorkers' Compensation Claim Representative I - Remote (CA Jurisdiction, Future Medical / Lien Specialist) Location: Remote (reporting to Irvine, CA Branch)Schedule: Monday-Friday, 8:00 AM-4:30 PM PSTSalary Range: $60,000-$75,000 annuallyReports To: Workers' Compensation SupervisorAccounts: Multiple accounts within the staffing and transportation industries Build Your Career With Purpose at CCMSI At CCMSI, we don't just process claims-we support people. As a leading Third Party Administrator and a certified Great Place to Work, we offer manageable caseloads, employee ownership, and a collaborative culture. Our employee-owners are empowered to grow, contribute, and make a meaningful impact every day. Job Summary We are seeking an experienced Workers' Compensation Claim Representative I to handle California jurisdiction claims with a focus on lien resolution and lifetime medical management. This remote position supports multiple accounts within the staffing and transportation industries and requires an individual who can manage complex medical issues, negotiate lien settlements, and maintain strong compliance with state and client requirements. This role is ideal for someone who enjoys analytical problem-solving, communicating with medical providers and attorneys, and driving claims toward fair and timely resolution.

Responsibilities

• Investigate, evaluate, and adjust workers' compensation claims in accordance with established procedures and California regulations.
• Negotiate and settle liens with lien claimants, medical providers, and applicant attorneys.
• Handle future medical/lifetime medical claims, ensuring timely authorization and payment of treatment, services, and prescriptions.
• Review medical reports, legal correspondence, and billing to determine reasonableness and relatedness to ongoing claims.
• Coordinate with defense counsel and vendors to resolve complex lien disputes.
• Maintain current and accurate diary, documentation, and billing records.
• Ensure compliance with CCMSI standards, client requirements, and jurisdictional timeframes.
• Deliver exceptional customer service to clients, claimants, and internal partners.

QualificationsRequired:

• Minimum 2 years of workers' compensation claim handling experience, with exposure to lien resolution and/or lifetime medical management.
• SIP certification or Experienced Adjuster designation.
• Excellent written and verbal communication skills.
• Strong time management and organizational abilities with attention to detail.
• Proficiency in Microsoft Office programs (Word, Excel, Outlook).

Preferred:

• Prior experience managing claims within the staffing or transportation industries.

Performance Metrics Performance is measured by accuracy and timeliness of diary entries, documentation, and bill processing; quality of claim handling; and adherence to client and corporate standards.

What We Offer

• Employee Ownership: As an Employee-Owned Company (ESOP), every employee has a stake in our success.
• Time Off: 4 weeks of paid time off in your first year, plus 10 paid holidays.
• Comprehensive Benefits: Medical, Dental, Vision, Life, Short- and Long-Term Disability, Critical Illness, and 401(k).
• Career Growth: Robust internal training and professional development opportunities.
• Supportive Culture: We believe in manageable caseloads, collaboration, and maintaining a healthy work-life balance.

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. 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. 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: Act with integrity Deliver service with passion and accountability Embrace collaboration and change Seek better ways to serve Build up others through respect, trust, and communication Lead by example-no matter their title We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #NowHiring #WorkersCompensation #ClaimsAdjuster #LienResolution #RemoteJobs #InsuranceCareers #CaliforniaClaims #CareerGrowth #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #LI-Remote #WorkersComp #WorkersCompensationJobs #WCAdjuster #ClaimsJobs #AdjusterJobs #InsuranceJobs #RemoteAdjuster #CaliforniaJobs #CaliforniaAdjusters #InsuranceProfessionals #RiskManagementJobs #LegalSupportJobs #TPACareers #ClaimsHandling #LienSpecialist #FutureMedicalClaims #RemoteWork #HiringNow #RemoteCareers #JobSearch Employment Type: OTHER Apply tot his job Apply To this Job