Workers' Compensation Claim Consultant (Remote - NY/NJ Jurisdictions)

Position Title: Workers’ Compensation Claim Consultant Location: Remote - reporting to Wall Township, NJ Hours: Monday - Friday, 8:00 AM to 4:30 PM EST Salary Range: $80,000 - $85,000 The posted salary reflects CCMSI’s good-faith estimate of the base pay range for this role, in accordance with applicable pay transparency laws. Actual compensation will depend on qualifications, experience, and internal equity. Additional compensation may include bonuses, benefits, or other forms of pay. A full summary of benefits—including Medical, Dental, Vision, Life Insurance, ESOP, and 401K—is available upon request. Please discuss any compensation and benefits questions with our hiring team. About CCMSI: At CCMSI, we seek the best and brightest talent to join our team of professionals. As a leading Third Party Administrator specializing in self-insurance services, we are committed to delivering exceptional service to our clients. As an Employee-Owned Company, we invest in our employees through career development, training, and recognition programs. Certified as a Great Place to Work, we take pride in a culture that fosters integrity, passion, and excellence. About the Role: The Workers’ Compensation Claim Consultant is responsible for overseeing a multiple-account desk within the New York jurisdiction while also managing select claims from New Jersey. This position requires an in-depth understanding of New York Workers’ Compensation laws and regulations, ensuring timely and effective claims management. The role demands a proactive approach to claims handling, with an emphasis on high-quality service, effective litigation management, and compliance with corporate and client standards. This position also offers opportunities for professional growth and career advancement. What You’ll Do As a Workers' Compensation Claim Consultant, you’ll manage claims from investigation through resolution within New York and New Jersey jurisdictions. This desk handles multiple accounts accross varies industries. Key responsibilities include: • Claims Adjustment: Investigate, evaluate, and adjust workers' compensation claims in compliance with NY and NJ laws, as well as client-specific guidelines. • Reserve Management: Establish and recommend reserves within established authority levels. • Billing Oversight: Analyze medical, legal, and damage invoices for reasonableness and negotiate disputed bills as necessary. • Claim Payments: Authorize and process payments in accordance with industry standards and settlement authority. • Settlements: Negotiate settlements with claimants and attorneys, ensuring compliance with state laws and client authorizations. • Vendor Collaboration: Partner with defense attorneys and manage relationships with external vendors for legal, surveillance, and case management services. • Reporting: Prepare detailed reports on claim statuses, payments, and reserves, and provide updates for excess insurers. • Service Excellence: Deliver exceptional claim services to CCMSI clients, adhering to our corporate standards. • Hearings & Legal Proceedings: Represent CCMSI at hearings, mediations, and legal conferences as needed. What You Bring to the Table Must-Have Skills: • 5+ years of experience handling New York Workers’ Compensation claims. • Deep knowledge of New York Workers’ Compensation laws. • New York Adjuster’s License (required). • Strong organizational skills with the ability to prioritize multiple tasks effectively. • Proficiency in Microsoft Office (Word, Excel, Outlook). • Excellent written and verbal communication skills.

Nice-to-Have

Skills: • Experience managing claims across multiple jurisdictions. Core Values & Principles: At CCMSI, we are committed to: ? Acting with integrity and professionalism. ? Providing client-centered service with passion and enthusiasm. ? Seeking innovation and continuous improvement. ? Fostering a culture of collaboration, trust, and respect. Why Join CCMSI? ? Culture - We value our employees as partners and foster an environment of integrity, passion, and enthusiasm. ? Career Development - Internal training programs and advancement opportunities. ? Benefits - 4 weeks of PTO in your first year + 10 paid holidays, Medical, Dental, Vision, Life Insurance, Critical Illness, Short & Long-Term Disability, 401K, and Employee Stock Ownership Plan (ESOP). ? Work Environment - Supportive, team-oriented workplace with manageable caseloads and resources for success. CCMSI is an Affirmative Action / Equal Employment Opportunity employer. Background checks are conducted in compliance with applicable laws. Ready to Elevate Your Career? This is an exciting opportunity to grow your expertise in claims management while contributing to the success of a dynamic, nationwide organization. If you’re ready to take the next step in your career, apply today and join our exceptional team at CCMSI! Apply today to join a dynamic team focused on professional growth and delivering exceptional service!#CCMSICareers #Hiring #JoinOurTeam #NowHiring #CareerGrowth #GreatPlaceToWork #EmployeeOwned #WorkLifeBalance #EmployeeBenefits #ESOP #TPACareers #WorkersCompensation #RemoteWork #ClaimConsultant #InsuranceCareers #EmployeeOwned #GreatPlaceToWork #AttentionToDetail #Collaboration #NYWorkComp #NJWorkComp #IN123 Apply Job!