Top 29 Claims consultant Jobs in Irvine, Ca

Workers' Compensation Claim Consultant
CCMSI —Irvine, CA
- $80,000 - $95,000 a year
- Full-time
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Paid holidays
- Disability insurance
Formulary Consulting Group Lead - Remote
Optum —Irvine, CA
- $112,700 - $193,200 a year
- Full-time
- Remote
- Pass drug screening
- Mid-level
- Travel
Quick Apply
Program Manager Clinical, Consultant (Small To Mid)
Blue Shield of California —Long Beach, CA
- $111,540 - $167,420 a year
- Full-time
- Hybrid work
- Background check
- 7 years
- LVN
- Work from home
4d
Workplace Safety & Risk Management Consultant Grocery / Retail
3S Insurance Services —Irvine, CA
- $30 - $50 an hour
- Part-time
- Grocery store experience
- In-person
- Leadership
- Flexible schedule
Quick Apply
Senior Consultant (Polymers)
Engineering Systems Inc —Santa Ana, CA
- $120,000 - $180,000 a year
- Full-time
- Construction site
- Residential
- Master's degree
- Paid holidays
- Health insurance
Sr Safety & Health Consultant
Zenith Insurance Company —Orange, CA
- $109,728.11 - $137,160.14 a year
- Full-time
- 3 years
- Master's degree
- High school diploma or GED
- Paid training
- Paid parental leave
Manager, Schedule Delay Claims
The Vertex Companies, LLC —Irvine, CA
- $72,000 - $202,000 a year
- Full-time
- 3 years
- Master's degree
- Analysis skills
- Paid holidays
- Disability insurance
Senior Managing Consultant (Metallurgy)
Engineering Systems Inc —Santa Ana, CA
- Full-time
- 6 years
- Construction site
- Residential
- Paid holidays
- Health insurance
FP&A Advise Senior Consultant
Deloitte —Costa Mesa, CA
- $116,200 - $229,100 a year
- Full-time
- CPA
- Up to 50% travel
- Finance
Senior Advisor (Managed Care)
CorVel Corporation —Irvine, CA
- $99,250 - $166,777 a year
- Full-time
- Remote
- 5 years
- Analysis skills
- Presentation skills
- Health savings account
- Disability insurance
Quick Apply
Service Consultant
Gallagher Benefit Services —Irvine, CA
- $112,000 - $218,500 a year
- 7 years
- Up to 50% travel
- Bachelor's degree
3d
Risk Services Consultant II - LA & Riverside Region
Tokio Marine North America (TMNA) —Mission Viejo, CA
- $97,000 - $108,500 a year
- Online Application
- 7 years
- Engineering
- Senior level
- Health insurance
- Tuition reimbursement
Senior Consultant (Mechanics)
Engineering Systems Inc —Anaheim, CA
- $120,000 - $180,000 a year
- Full-time
- Construction site
- Office
- Residential
- Paid holidays
- Health insurance
Healthcare Revenue Cycle Billing Specialist II (SNF)
Wipfli —Irvine, CA
- $23 - $30 an hour
- Remote
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Health savings account
- AD&D insurance
Risk Services Consultant II - LA & Riverside Region
Philadelphia Insurance Companies (PHLY) —Mission Viejo, CA
- $97,000 - $108,500 a year
- Online Application
- 7 years
- Engineering
- Senior level
- Health insurance
- Tuition reimbursement
Health Actuary Consultant
Deloitte —Costa Mesa, CA
- $100,400 - $197,900 a year
- Full-time
- Microsoft Excel
- Up to 50% travel
- Mid-level
Staff Consultant (Crash Reconstructionist)
Engineering Systems Inc —Santa Ana, CA
- $100,000 - $125,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Construction site
- Paid holidays
- Health insurance
Senior Staff Consultant - Civil Structural Engineer
Engineering Systems Inc —Santa Ana, CA
- $85,000 - $130,000 a year
- Full-time
- Construction site
- Computer literacy
- Bachelor of Science
- Paid holidays
- Health insurance
Health Actuary Senior Consultant
Deloitte —Costa Mesa, CA
- $128,000 - $252,500 a year
- Full-time
- Up to 50% travel
- SQL
- Analysis skills
Consulting Manager, Program Manager- Healthcare
Cognizant —Long Beach, CA
- $100,000 - $129,500 a year
- Full-time
- Remote
- Presentation skills
- Senior level
- Leadership
- Paid parental leave
- Employee stock purchase plan
2d

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claims consultant jobs near irvine, ca

Workers' Compensation Claim Consultant

CCMSI -
Irvine, CA

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Job Details

Full-time
$80,000 - $95,000 a year

Benefits

Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Employee stock ownership plan
Opportunities for advancement

Qualifications

Microsoft Excel
Microsoft Outlook
Workers' compensation insurance knowledge
Litigation

Full Job Description

Overview:

Workers' Compensation Claim Consultant
Location: Irvine, CA (reporting remotely)
Schedule: 8:00 am - 4:30 pm (PST)
Salary Range: $80,000 - $95,000 (depending on experience)

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 and highly skilled California Workers’ Compensation Claim Consultant to manage a complex portfolio of claims with confidence, empathy, and sound professional judgment. With 5+ years of hands‑on claims experience, you will lead thorough investigations, guide claim strategy, and ensure fair, timely resolutions. This role also offers a strong development pathway for advancement into more senior claim positions. As a Claim Consultant, you will play a key role in delivering exceptional service to CCMSI clients and upholding our high standards of quality and responsiveness.

This is a full life‑cycle WC adjuster position within a TPA environment, and only candidates with proven Workers’ Compensation claims experience will be considered.

Responsibilities:

When we hire Workers’ Compensation Adjusters at CCMSI, we look for detail‑driven problem‑solvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust.

Investigate, evaluate, and adjust claims in compliance with company standards and applicable laws.
Establish and manage reserves within authority guidelines.
Review, approve, and negotiate medical, legal, damage estimate, and related claim expenses.
Authorize claim payments and negotiate settlements within established authority and client-specific guidelines.
Coordinate and oversee external vendors, including legal counsel, surveillance, and case management providers.
Monitor claim progression, including subrogation opportunities, diary management, and reporting requirements.
Maintain timely communication with clients, claimants, and other stakeholders throughout the claim lifecycle.
Provide claim status updates, reserve analyses, and other reports as requested.
Calculate disability rates and ensure compliance with applicable state regulations.
Notify excess and reinsurance carriers of qualifying claims.
Handle complex claims independently with minimal supervision.
Participate in hearings, mediations, legal conferences, client meetings, training sessions, and claim reviews, as appropriate.
Support client satisfaction through responsive service and adherence to corporate claim handling standards and client instructions.
Contribute to special projects, training materials, newsletters, and other departmental initiatives as requested.

Qualifications:

Required Qualifications

5+ years of California Workers’ Compensation claims experience.
Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
SIP is required, or you must be able to obtain.
Experience handling a mostly litigated workload.

Preferred Qualifications

Bachelor’s degree is preferred but not required.
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.

#CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #TPA #InsuranceCareers #ClaimsCareers #IrvineJobs #CaliforniaJobs #CareerGrowth #IND123 #LI-Remote

Apply Now

Refine Your Search

claims consultant jobs in irvine, ca

Workers' Compensation Claim Consultant

Formulary Consulting Group Lead - Remote

Program Manager Clinical, Consultant (Small To Mid)

Workplace Safety & Risk Management Consultant Grocery / Retail

Senior Consultant (Polymers)

Sr Safety & Health Consultant

Manager, Schedule Delay Claims

Senior Managing Consultant (Metallurgy)

FP&A Advise Senior Consultant

Senior Advisor (Managed Care)

Service Consultant

Risk Services Consultant II - LA & Riverside Region

Senior Consultant (Mechanics)

Healthcare Revenue Cycle Billing Specialist II (SNF)

Risk Services Consultant II - LA & Riverside Region

Health Actuary Consultant

Staff Consultant (Crash Reconstructionist)

Senior Staff Consultant - Civil Structural Engineer

Health Actuary Senior Consultant

Consulting Manager, Program Manager- Healthcare

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Build Your Career With Purpose at CCMSI

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