Medical Claims Representative – Workers’ Compensation (Hybrid Las Vegas)

Overview

Workers’ Compensation Medical Only Claim Representative

Location: Las Vegas, NV (Hybrid Schedule)Schedule: Monday–Friday, 8:00 a.m. – 4:30 p.m. (37.5 hours per week)Compensation: $22.50 – $25.00 per hour, commensurate with experienceHybrid Schedule: After training, work from home Monday, Tuesday, and every other Wednesday

Build Your Career With Purpose at CCMSI

At CCMSI, we don’t just process claims—we support people. As one of the largest employee-owned Third Party Administrators in the country, 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

Join our Las Vegas claims team as a Workers’ Compensation Medical Only Claim Representative, where you’ll handle medical-only workers’ compensation claims for multiple client accounts across various industries. This position offers structured training, mentorship, and the opportunity to develop foundational adjusting skills in a supportive and collaborative environment.

You’ll be responsible for the timely and accurate adjudication of medical-only claims in compliance with Nevada statutes, client expectations, and CCMSI’s handling standards. This position may serve as a training role for future advancement to intermediate-level claim positions.

Responsibilities

• Adjudicate medical-only workers’ compensation claims timely and accurately in accordance with statutory, client, and CCMSI guidelines.

• Establish and maintain claim reserves within authority levels under direct supervision.

• Review, approve, and negotiate medical and miscellaneous invoices to ensure appropriate and related charges.

• Coordinate and monitor medical treatment in compliance with corporate claim standards.

• Document all claim activity, medical updates, and correspondence in the claim system.

• Close claim files when appropriate and assist with file maintenance as needed.

• Provide support to the broader claim team, including client service initiatives and administrative tasks.

• Maintain compliance with all Corporate Claim Standards and client-specific handling instructions.

Qualifications

Required:

• Associate degree or two (2) years of related business experience

• NV Adjuster’s License or ability to obtain within 60 days of hire (must pass state licensing exam and background check)

• Proficiency in Microsoft Office (Word, Excel, Outlook)

Preferred / Nice to Have:

• Previous workers’ compensation or claim handling experience

• Knowledge of medical terminology

Training & Development

Training is tailored to each employee’s needs and includes one-on-one instruction, group training sessions, and continuous mentoring and coaching throughout employment.

How We Measure Success

• Audit scores and compliance with handling standards

• Meeting claim deadlines and accuracy benchmarks

• Client satisfaction and service responsiveness

• Demonstrated ability to comprehend and follow established procedures

What We Offer

• 4 weeks PTO 10 paid holidays in your first year• Medical, Dental, Vision, Life, and Disability Insurance• 401(k) and Employee Stock Ownership Plan (ESOP)• Internal training and advancement opportunities• A supportive, team-based work environment

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. 

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.

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:• Act with integrity• Deliver service with passion and accountability• Embrace collaboration and change• Seek better ways to serve• Build up others through respect, trust, and communication• Lead by example—no matter their title

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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Salary : $22 - $25