Job Details

Overview

Workers' Compensation Claim Representative I

Location: Albuquerque, NM
Work Arrangement: Hybrid (after training)
Schedule: Monday-Friday, 8:00 AM to 4:30 PM
Salary Range: $55,000-$65,000

Build Your Career With Purpose at CCMSI

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.

Job Summary

The Workers' Compensation Claim Representative I is responsible for investigating and adjusting assigned workers' compensation claims in New Mexico. This role is ideal for professionals looking to grow into more senior-level claim positions. You'll manage claims from start to finish, ensuring compliance with NM Workers' Compensation regulations and CCMSI standards.

When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person's livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems.

Responsibilities

• Investigate and adjust workers' compensation claims in accordance with NM WC laws and CCMSI guidelines under direct supervision.

• Review medical, legal, and miscellaneous invoices; negotiate disputed bills when necessary.
• Authorize and process claim payments within settlement authority.

• Negotiate settlements with claimants and attorneys in compliance with NM WC statutes and client authorization.

• Assist in selecting and supervising defense attorneys.

• Monitor subrogation claims for resolution.

• Prepare reports detailing claims, payments, and reserves.

• Ensure compliance with service commitments and delivery of quality claim service to clients.

Qualifications

What You'll Bring

Required:

• 3+ years of Workers' Compensation claims experience or related insurance industry experience.

• Strong organizational skills with the ability to manage multiple tasks independently.

• Effective verbal and written communication skills for interaction with internal teams, clients, and external partners.

• Proficiency with Microsoft Office applications (Word, Excel, Outlook).

• Active NM adjuster license or ability to obtain within required timeframe.

• Reliable and predictable attendance during established hours.

Nice to Have:

• Associate's degree or higher, or equivalent insurance experience.

• Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required.

Why You'll Love Working Here

• 4 weeks PTO + 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

How We Measure Success

At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:

• Quality claim handling - thorough investigations, strong documentation, well-supported decisions
  • Compliance & audit performance - adherence to jurisdictional and client standards
  • Timeliness & accuracy - purposeful file movement and dependable execution
  • Client partnership - proactive communication and strong follow-through
  • Professional judgment - owning outcomes and solving problems with integrity
  • Cultural alignment - believing every claim represents a real person and acting accordingly

This is where we shine, and we hire adjusters who want to shine with us.

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. This role may also qualify for bonuses or additional forms of pay.

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. If you need assistance or accommodation, please contact our team.

Equal Opportunity Employer:

CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment.

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:

• Lead with transparency We build trust by being open and listening intently in every interaction.
• Perform with integrity We choose the right path, even when it is hard.
• Chase excellence We set the bar high and measure our success. What gets measured gets done.
• Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
• Win together Our greatest victories come when our clients succeed.

We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.

#WorkersCompensation #ClaimsRepresentative #InsuranceCareers #RiskManagementJobs #HybridJobs #AlbuquerqueJobs #NewMexicoCareers #JoinOurTeam #GreatPlaceToWork #EmployeeOwned #CCMSICareers #ClaimsAdjusterJobs #CareerGrowth #TPACareers #LI-Hybrid #IND123