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Claim Manager - Workers' Compensation - Las Vegas (Hybrid)
Overview
Claim Manager – Workers’ Compensation
Location: Las Vegas, NV — Hybrid
Schedule: Monday–Friday (Hybrid: on-site presence required weekly; travel required as needed)
Salary Range: $100,000–$125,000
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
We are seeking an experienced Workers’ Compensation Claim Manager to oversee a multi-account portfolio with a strong focus on Nevada jurisdictional requirements, litigation management, compliance oversight, and carrier deliverables. This hybrid position plays a critical leadership role in supervising claim handling quality, ensuring state-specific compliance, and supporting staff development in a fast‑paced TPA environment.
This role requires deep knowledge of Nevada workers’ compensation statutes, hearings processes, litigation strategy, auditing requirements, and EDI regulations. You will provide daily guidance to claim staff, coordinate escalated file activity, manage internal and external audits, and serve as a key partner to clients, carrier representatives, and internal leadership. Travel may be required.
Responsibilities
- Review, assign and provide supervision of all claim activity for designated claims to ensure compliance with Corporate Claim Standards, client specific handling instructions and in accordance with applicable laws.
- Investigate, evaluate and adjust assigned claims in accordance with established claim handling standards and laws.
- Reserve establishment and/or oversight of reserves for designated claims within established reserve authority levels.
- Provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution, as appropriate.
- Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
- Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
- Direct handling of designated litigated and complex claims.
- Provide education, training and assist in the development of claim staff.
- Review and maintain personal diary on claim system.
- Supervision of all claim activity for specified accounts.
- Attend account Board Meetings, conduct file review meetings and/or training sessions with clients, as requested.
- Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
- Performance appraisals and objective/goal setting and attainment of claim staff.
- Remain current on all legislative activity (both federal and state), industry and market trends to ensure that all staff members are appropriately informed and understand the impact of these developments.Develop revise and implement workflow processes to ensure efficiencies and provide oversight of individual caseloads, as appropriate.
- Monitor compliance with Corporate Claim Handling Standards and special client handling instructions statutes, rules and regulations, and relative case law.
Qualifications
Required:
- Active Nevada Adjuster License
- Nevada Hearings Representative License
- 3+ years of supervisory or management experience within workers’ compensation
- 10–15+ years of WC claims experience (or combination of degree + extensive experience)
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Demonstrated experience with:
- Litigation oversight, hearing participation, and file strategy
- Compliance monitoring, EDI, audits, and carrier reporting requirements
- Multi-account oversight within a TPA or carrier environment
- Reviewing, assigning, and supervising claim activity for adherence to standards and legal requirements
- Strong analytical, negotiation, and decision-making skills
- Ability to manage and mentor a team, provide coaching, and conduct performance evaluations
- Exceptional written and verbal communication skills
- High level of professionalism, confidentiality, and reliability
- Proficiency in Microsoft Office
Nice to Have:
- Experience with Nevada litigation, hearings, and compliance workflows
- AIC, CPCU, ARM, or other industry designations
- Background working in a multi-jurisdictional TPA environment
- Experience developing workflows, conducting training, and improving operational efficiency
- Strong understanding of EDI, audit formats, and carrier-specific deliverables
Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
Why You’ll Love Working Here
6 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
How We Measure Success
At CCMSI, great leaders deliver clarity, quality, and consistent results. For this Claim Manager role, success is measured by:
Compliance excellence – maintaining full adherence to Nevada regulations, EDI requirements, statutes, and audit standards- Team leadership & development – coaching, supporting, and elevating claim staff performance
- Quality oversight – ensuring investigations, documentation, reserving, and decisions meet corporate and client standards
- Litigation & hearing management – effective oversight of strategy, preparation, and representation
- Operational performance – timely deliverables, audit readiness, workload prioritization, and account stewardship
- Client satisfaction & responsiveness – proactive communication, problem resolution, and partnership
- Cultural alignment – acting with integrity, ownership, and commitment to our employee‑owned values
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.
CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.
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.
Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.
Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.
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.
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