Claim Representative, Medical Only

Overview
Position Title : Workers' Compensation Claim Adjuster, Medical Only (FL)
Location : Branch located in Maitland, FL (Greater Orlando Area)
Hours : Monday - Friday, 8:00 AM to 4:30 PM ET
Salary Range : $23/hr - $25/hr
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 Medical Only Claim Representative is responsible for claims handling of designated medical only claims and provide support to claim staff. This position may be used as a training position for consideration of promotion to an intermediate level claim position. Is accountable for the quality of claim services as perceived by CCMSI clients and within the corporate claim standards.
Responsibilities
When we hire claim reps at CCMSI, we look for detail oriented professionals who understand that every task supports a real person’s claim experience, value accuracy and responsiveness, and contribute to the team’s success through organization, collaboration, and a strong commitment to service.
Set up and manage medical‑only claim files in accordance with corporate claim standards and applicable laws
Establish reserves and provide reserve recommendations within authorized levels under direct supervision
Review and approve medical and miscellaneous invoices on designated claims; negotiate disputed bills or invoices under supervision
Request and monitor medical treatment in accordance with corporate claim handling standards
Summarize correspondence and medical records in claim system notes and file documentation appropriately
Close claim files when appropriate and retrieve closed files for re‑filing as requested
Provide ongoing support to claim staff on client service teams
Communicate with medical providers, injured workers, and internal partners; frequent phone work is required
Ensure compliance with corporate claim handling standards and special client handling instructions
Qualifications
Required:
Associate Degree or two (2) years of related business experience
Customer‑service oriented mindset with comfort communicating by phone
Strong organizational skills and ability to multitask effectively
Ability to work efficiently on a computer and manage detailed documentation
Proficiency with Microsoft Office applications including Word, Excel, and Outlook
Reliable, predictable attendance during assigned business hours.
Experience adjusting FL medical only claims, other possible jurisdictions.
Nice To Have
Knowledge of medical terminology
Prior experience in claims, insurance, or medical administrative support
Experience supporting a single client or program environment
Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.
Why You’ll Love Working Here
4 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 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.
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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Work arrangement
Yes