Workers' Compensation Claim Consultant
About The Position
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. The Workers’ Compensation Claim Consultant is responsible for the investigation, evaluation, and adjustment of assigned workers’ compensation claims across a multi state desk, primarily supporting Wisconsin, Illinois, Indiana, and Michigan with additional exposure to Iowa and Kentucky. This role manages claims from start to finish (cradle to grave) and plays a key role in delivering high‑quality claim outcomes in alignment with CCMSI standards and client expectations. This is a multiple‑account desk within a fast‑paced TPA environment. The position offers two weeks of structured training with management and colleagues before assuming a pending caseload, followed by continued support as claims are assigned. After training, the role transitions to a hybrid schedule with two in‑office days per week.
Requirements
- 5+ years of workers’ compensation claim handling experience
- Experience managing full life‑cycle (cradle‑to‑grave) WC claims
- Strong Wisconsin workers’ compensation knowledge is very helpful
- Experience handling multi‑state claims, primarily WI, IL, and IN
- Ability to manage a multiple‑account desk independently
- Active Texas adjuster license is preferred
- Strong analytical, organizational, and decision‑making skills
- Excellent written and verbal communication skills
- Ability to manage workload in a fast‑paced environment with minimal supervision
- Proficiency with Microsoft Office and claim management systems
Nice To Haves
- Experience handling claims in Iowa and/or Kentucky
- Prior experience in a TPA environment
- Litigation management experience
- Bachelor’s degree
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
Responsibilities
- Investigate workers’ compensation claims by reviewing accident details, medical records, wage information, and employment history
- Determine compensability and claim strategy in accordance with applicable state laws and client handling instructions
- Establish, monitor, and adjust claim reserves accurately based on exposure and claim progression
- Coordinate medical treatment to ensure timely, appropriate, and cost‑effective care
- Issue indemnity and medical payments accurately and within statutory timelines
- Communicate effectively with injured workers, employers, attorneys, medical providers, and internal partners
- Document all claim activity clearly, thoroughly, and timely within the claim management system
- Manage litigated claims in collaboration with defense counsel, including strategy discussions and status updates
- Identify and pursue subrogation opportunities when applicable
- Monitor claim diaries and take proactive action to move claims toward resolution
- Prepare claim summaries, reports, and client updates as requested
- Participate in client claim reviews or training sessions when needed
- Maintain compliance with corporate claim handling standards, audit requirements, and jurisdictional regulations
Benefits
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
1-10 employees
