Insurance Claims Assistant - Workers' Compensation - In Office (Irvine, CA) - CCMSI

Join CCMSI as a Claim Assistant - Onsite Position in Irvine, CA

Schedule: Monday - Friday, 8:30 am to 4:30 pm
Location: In-office role

Are you detail-oriented, highly organized, and driven to provide top-tier service? CCMSI, a recognized leader in self-insurance services, is seeking a dedicated Claim Assistant to support a dynamic team of 4-5 California Workers’ Compensation adjusters. As an Employee-Owned Company, CCMSI invests in your career growth, offers robust benefits, and fosters a culture that celebrates integrity, passion, and enthusiasm.

Key Responsibilities:

• Assist 4-5 examiners with administrative tasks, including benefit notices, serving records, fax retrieval, mail handling, and phone support.
• Coordinate various clerical duties and manage general office equipment.
• Provide responsive service to both internal and external clients.

Required Skills:

• Strong multi-tasking abilities and a proactive, self-starter attitude.
• Excellent communication skills (oral and written) and exceptional typing proficiency.
• Ability to prioritize and handle rush assignments with flexibility.
• Collaborative team player with a commitment to confidentiality and discretion.

Preferred Qualifications:

• Knowledge of medical terminology.
• Prior experience in a fast-paced, client-focused environment.

Why Choose CCMSI?

• Culture: Join an employee-centric workplace where our core values—integrity, passion, and enthusiasm—are the foundation of our success.
• Career Development: Enjoy opportunities for growth through structured training and development programs.
• Competitive Benefits: Start with 4 weeks of paid time off, plus 10 paid holidays, Medical, Dental, Vision, Life Insurance, Short & Long-Term Disability, 401K, and Employee Stock Ownership Plan (ESOP).

CCMSI is certified as a Great Place to Work, with employee satisfaction and retention in the 95th percentile. Here, you’ll find an environment that’s committed to your success, where your contributions make a difference every day.

Apply today and become a valued member of our team!

• Investigate, evaluate and adjust contested medical-only claims and handle indemnity claims under direct supervision.  
• Establish reserves and/or provide reserve recommendations within established authority levels under direct supervision. 
• Set up designated claim files and complete all set up instructions, as requested. 
• Set up independent medical exams as deemed necessary under direct supervision. 
• Request and monitor medical treatment of designated claims in accordance with corporate claim standards. 
• Review and approve related medical, legal, damage estimates and miscellaneous invoices on designated claims. Negotiate any disputed bills/invoices for resolution under direct supervision. 
• Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws under direct supervision, when appropriate. 
• As appropriate, make referrals to outside vendors on designated cases under direct supervision. (i.e. legal, surveillance, case management, etc.) 
• Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process. 
• Authorize and make payments on claims utilizing a claim payment program in accordance with industry standards and within established authority levels under direct supervision. 
• Compute disability rates in accordance with state laws under direct supervision, when appropriate. 
• Summarize all correspondence and medical records in claim log notes as well as file same in the appropriate claim. 
• Return provider calls. 
• Review and maintain personal diary on claim system. 
• Provide technical and clerical claims support to designated clients, as requested.  
• Compliance with corporate claim standards and special client handling instructions as established. 
• Other duties, as assigned.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Excellent oral and written communication skills.
• Individual must be a self-starter with strong organizational abilities.
• Ability to coordinate and prioritize required.
• Ability to operate general office equipment and perform clerical duties.
• Flexibility, initiative, and the ability to work with a minimum of direct supervision a must.
• Discretion and confidentiality required.
• Ability to work as a team member in a rapidly changing environment.
• Reliable, predictable attendance within client service hours for the performance of this position.
• Responsive to internal and external client needs.
• Ability to clearly communicate verbally and/or in writing both internally and externally.

Education and/or Experience    

Associate’s degree or two year’s related business experience.

Knowledge of medical terminology preferred.

Computer Skills            

Proficient with Microsoft Office programs.

Certificates, Licenses, Registrations

none required.

CORE VALUES & PRINCIPLES

Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.

CCMSI is an Affirmative Action / Equal Employment Opportunity employer offering an excellent benefit package including Medical, Dental, Prescription Drug, Vision, Flexible Spending, Life, ESOP and 401K.  

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