Workers Compensation Claim Representative I

$60,000 - $74,000/Yr

Ccmsi - Englewood, CO

Full-time - Entry Level

Englewood, CO

Insurance Carriers and Related Activities

About the position

The Workers' Compensation Claim Representative I is responsible for investigating and adjusting assigned workers' compensation claims. This entry-level position serves as a foundational role with potential for advancement to more senior claim positions. The representative is accountable for delivering quality claim services in line with CCMSI's corporate standards and client expectations.

Responsibilities

• Investigate and adjust workers compensation claims according to established procedures.
• Review medical, legal, and miscellaneous invoices for reasonableness and relevance to claims.
• Negotiate disputed bills for resolution.
• Authorize and process payments for workers compensation claims within settlement authority.
• Negotiate settlements with claimants and attorneys as per client authorization.
• Assist in selecting and supervising defense attorneys.
• Assess and monitor subrogation claims for resolution.
• Prepare detailed reports on claims, payments, and reserves.
• Provide reports and monitor files as required by excess insurers.
• Ensure compliance with service commitments established by the team.
• Deliver quality claim service to clients.
• Perform other duties as assigned.

Requirements

• 3 or more years of workers compensation claim experience or related industry experience.
• Excellent oral and written communication skills.
• Strong organizational abilities and self-starter mentality.
• Ability to coordinate and prioritize tasks effectively.
• Flexibility and initiative to work with minimal supervision.
• Discretion and confidentiality in handling sensitive information.
• Ability to work as a team member in a dynamic environment.
• Reliable attendance during client service hours.

Nice-to-haves

• Associates degree is preferred.
• Adjuster's license may be required based on jurisdiction.
• Proficient in Microsoft Office programs such as Word, Excel, and Outlook.

Benefits

• Medical, Dental, Prescription Drug, Vision, Flexible Spending, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP.
• 4 weeks paid time off in the first year plus 10 paid holidays.