Pacific Claims Management (PCM) stands out from our competitors due to our unwavering dedication to our clients. Our unwavering dedication is driven by our commitment to deliver more than your typical TPA. This includes understanding the challenges that our clients face and delivering solutions in excess insurance, audits, vendor management, actuarial compliance, financial planning/budgeting, and operational development. We’ve done it all.

What we’re known for, however, is superior claims management. When we became a licensed TPA in 2011, it was apparent that the industry had a need for transparency in management, fee structures, and vendor relationships. We knew we could do better, and at a better price, which is why our flat-rate contracts have become so popular with our clients. It’s also the reason we have earned a strong reputation and fierce loyalty from our clients over the past decade.

Our Mission

Pacific Claims Management (PCM) is dedicated to helping employers make their workers’ compensation programs as efficient, effective, and affordable as possible. We do this through superior claims management and boutique-level service to the companies we serve and their injured workers.

Who We Are

  • We are a team. Our nearly 50 employees handle accounts of more than $800 million in payroll.
  • We are bilingual. More than 50% of our staff speaks both English and Spanish.
  • We are cutting-edge. Our claims system is the first of its kind and built on a Microsoft backbone.
  • We are proven. Our clients have saved 50% to 85% in workers’ compensation program costs.
  • We are advocates for self-insurance. We have administered claims for more than 100 self-insured employers.
  • We are PCM. We are committed to performance, accountability, transparency, and honor.

Our Values

Performance: We have an irrefutable record of reducing cost with consistent reserve stability through efficient claims handling.

Accountability: We offer effective and accountable claims management customized for each employer’s needs.

Transparency: We utilize consistently effective processes anchored through communication, partner involvement, and results.

Honor: We take pride in establishing a strong bond and lasting relationship with our clients, resulting in a high level of client retention.

We’ll improve your claims administration experience through:

  • Strong client connections, relationships, and retention
  • Reduced claims costs and duration
  • Consistency in reserve management
  • Timely information on legislation, judicial updates, and industry information
  • Close ties with state and federal agency leadership
  • Operational and cultural change for employers
  • Flexibility on fee structures

Testimonials

“Redondo Beach Unified School District has been able to pay for the district’s employee benefits program with the savings we’ve incurred from our self-insured workers’ compensation program. This has only been possible with the guidance and continued support of Pacific Claims Management.”

Janet Redella, Assistant Superintendent, Administrative Services, RBUSD

“At a time when public transit providers across the state are scraping together funds to save their programs, PCM has helped us save enough money to assist in funding our operating expenses and expand our services to the community each year. We’re now seeing our highest year of ridership since 2008.”

Kelly Halcon, Director of Human Resources and Risk Management, Monterey-Salinas Transit

Our Results

  • PCM Helps Transit Authorities Save Jobs and Money Through Reliable Workers’ Comp Claims Administration [Link]
  • School District Saves ~$1 Million Per Year with Self-Insured Workers’ Comp Program [Link]

Q&A with Our Adjusters

Anthony: Agricultural, Schools, Transportation, Medical Field.

Tracey: Public Transit, Churches, Agricultural, Construction.

Adam: Healthcare Providers and Industrial Metal Fabricators. I also administer all COVID-19 claims for our clients.

Ryan: I am currently assigned to a large farm labor contractor account. I have experience with public entities, school districts, transit authorities, medical facilities, and insurance policy accounts.

Margot: Long-term residential care for the elderly.

Sandy: PCM provides in-house training that consists of on-the-job training, IEA workers’ comp classes, and pre-exam training for SIP, WCCA, and WCCP certifications. PCM also provides continuing educational training for CEU hours needed for adjusters through in person seminars, webinars, and outsourced seminars. PCM is an active sponsor for FICA and PIWC: two nonprofit professional groups in Fresno that provide education for adjusters, nurses, and attorneys.

Margot: PCM offers great training opportunities for people who are new to the workers’ comp field, such as WC introduction classes, classes to advance your WC career, trainings from law firms/doctors/WC auditors, and lunch trainings.

Monica: Great training opportunities are available here at PCM. I think PCM does a great job of offering outside training resources such as IEA Training and allowance for continued education. PCM also has internal training where you are cross-trained in different jobs depending on what type of job you have. Also, PCM does a great job at making available and continuing to train supervisors, management, and co-workers to ask questions when needed.

Jennifer: PCM offers numerous webinars and training throughout the year to help us adjusters keep up with our continuing education credits to maintain our SIP certification. PCM also provided me with the necessary courses to be able to take my SIP exam to earn my SIP certification.

Dila: Fast pace, critical thinking, helping people.

Moraima: My favorite thing about being an adjuster has been the ability to be able to help injured workers understand the process when one has an injury and to make them feel confident and comfortable in asking questions and having the easiest transition back to work after they recover. As a daughter of two parents who came to this country and didn’t understand or speak the language, it gives me motivation and satisfaction when I am able to help someone like my parents who may need help translating step by step and answering all questions they may have.

Tracey: I like being able to provide guidance to my clients and injured workers. I enjoy educating the clients on ways to better serve their employees when injuries occur and working with the injured worker to get them the treatment and benefits necessary to get them well and back to work.

Michelle: As a claims adjuster, there is always something to do and something new to learn.

Dila: I once received a thank you card from a 76-year-old injured worker. I’m also proud of the subrogation recoveries I have received for my client.

Adam: Pacific Claims Management provides such a unique opportunity to begin a career in workers’ compensation with an expedited training program. I was the first individual to partake in this program, and I completed and passed the State of California Self-Insurance examination on my first attempt. I couldn’t have done it without my wonderful co-workers and support system at PCM.

Ryan: The account that I supervise has had a significant reduction in open claims and reserves through the work my adjusters and myself. This provides the injured workers more access to the adjusters and a better response time by the adjusters simply by having the lower caseloads.

Monica: I was able to obtain information to successfully convict a worker for workers’ compensation fraud earlier this year. It was the first conviction of fraud for me and PCM. I am also proud of helping my account get better and better each year in terms of reserves and claims closed.

Moraima: It makes me proud to be working for PCM for many reasons, makes me proud to know we have scored well during different audits. It feels good knowing we all take pride in our work every day. We have amazing bosses who have really showed they care about their employees, the opportunities they provide, and the friendships created over the years here are the best. We have all grown to be close to one another and I see us like one big family.

Christina Miranda: We are given the tools to become successful and the support that management gives us not only in our work lives but also our personal lives—they are so understanding, empathic, and genuinely concerned about us. We are a true work family. I have never worked for a company that gives as much as PCM does and I don’t see myself working for any other company!

Sandy: PCM leadership takes ownership for providing a place of business for their clients that is ethical and honest—a partnership for both PCM and the client—and is loyal to their clients and employees. PCM is able to mix old school methodology with new wave technology for claims handling that complements the service provided to all clients.

Priscilla: Coffee first…then tackle daily tasks/diaries, reviewing medical reports, communicating with injured employees and clients daily, and adjusting expenses to ensure each claim is funded properly.

Moraima: My days consist of working my claim diaries, receiving calls from injured employees needing assistance or who may have different questions, setting up and working new claims, contacting doctors’ offices/attorneys, working incoming mail including request for authorizations, paying medical/legal/other bills, closing/settling claims, and deciding what we will have for lunch.

Adam: I provide claims management services for my clients to achieve the best possible outcome for both my employers and injured workers, while maintaining the integrity of California labor code ensuring all audit compliance is achieved.

Jennifer: A typical day for me is getting to the office, seeing what new claims I have, reaching out to the injured workers to see how they are doing with their injuries, and trying to get them the necessary treatment they need authorized within a timely manner to help get them back out to work.

Pacific Claims Management (PCM) stands out from our competitors due to our unwavering dedication to our clients. Our unwavering dedication is driven by our commitment to deliver more than your typical TPA. This includes understanding the challenges that our clients face and delivering solutions in excess insurance, audits, vendor management, actuarial compliance, financial planning/budgeting, and operational development. We’ve done it all.

What we’re known for, however, is superior claims management. When we became a licensed TPA in 2011, it was apparent that the industry had a need for transparency in management, fee structures, and vendor relationships. We knew we could do better, and at a better price, which is why our flat-rate contracts have become so popular with our clients. It’s also the reason we have earned a strong reputation and fierce loyalty from our clients over the past decade.

Our Mission

Pacific Claims Management (PCM) is dedicated to helping employers make their workers’ compensation programs as efficient, effective, and affordable as possible. We do this through superior claims management and boutique-level service to the companies we serve and their injured workers.

Who We Are

  • We are a team. Our nearly 50 employees handle accounts of more than $800 million in payroll.
  • We are bilingual. More than 50% of our staff speaks both English and Spanish.
  • We are cutting-edge. Our claims system is the first of its kind and built on a Microsoft backbone.
  • We are proven. Our clients have saved 50% to 85% in workers’ compensation program costs.
  • We are advocates for self-insurance. We have administered claims for more than 100 self-insured employers.
  • We are PCM. We are committed to performance, accountability, transparency, and honor.

Our Values

Performance: We have an irrefutable record of reducing cost with consistent reserve stability through efficient claims handling.

Accountability: We offer effective and accountable claims management customized for each employer’s needs.

Transparency: We utilize consistently effective processes anchored through communication, partner involvement, and results.

Honor: We take pride in establishing a strong bond and lasting relationship with our clients, resulting in a high level of client retention.

We’ll improve your claims administration experience through:

  • Strong client connections, relationships, and retention
  • Reduced claims costs and duration
  • Consistency in reserve management
  • Timely information on legislation, judicial updates, and industry information
  • Close ties with state and federal agency leadership
  • Operational and cultural change for employers
  • Flexibility on fee structures

Testimonials

“Redondo Beach Unified School District has been able to pay for the district’s employee benefits program with the savings we’ve incurred from our self-insured workers’ compensation program. This has only been possible with the guidance and continued support of Pacific Claims Management.”

Janet Redella, Assistant Superintendent, Administrative Services, RBUSD

“At a time when public transit providers across the state are scraping together funds to save their programs, PCM has helped us save enough money to assist in funding our operating expenses and expand our services to the community each year. We’re now seeing our highest year of ridership since 2008.”

Kelly Halcon, Director of Human Resources and Risk Management, Monterey-Salinas Transit

Our Results

  • PCM Helps Transit Authorities Save Jobs and Money Through Reliable Workers’ Comp Claims Administration [Link]
  • School District Saves ~$1 Million Per Year with Self-Insured Workers’ Comp Program [Link]

Q: What kind of clients do you work with?

Anthony: Agricultural, Schools, Transportation, Medical Field.

Tracey: Public Transit, Churches, Agricultural, Construction.

Adam: Healthcare Providers and Industrial Metal Fabricators. I also administer all COVID-19 claims for our clients.

Ryan: I am currently assigned to a large farm labor contractor account. I have experience with public entities, school districts, transit authorities, medical facilities, and insurance policy accounts.

Margot: Long-term residential care for the elderly.

Q: What type of training opportunities does Pacific Claims Management offer?

Sandy: PCM provides in-house training that consists of on-the-job training, IEA workers’ comp classes, and pre-exam training for SIP, WCCA, and WCCP certifications. PCM also provides continuing educational training for CEU hours needed for adjusters through in person seminars, webinars, and outsourced seminars. PCM is an active sponsor for FICA and PIWC: two nonprofit professional groups in Fresno that provide education for adjusters, nurses, and attorneys.

Margot: PCM offers great training opportunities for people who are new to the workers’ comp field, such as WC introduction classes, classes to advance your WC career, trainings from law firms/doctors/WC auditors, and lunch trainings.

Monica: Great training opportunities are available here at PCM. I think PCM does a great job of offering outside training resources such as IEA Training and allowance for continued education. PCM also has internal training where you are cross-trained in different jobs depending on what type of job you have. Also, PCM does a great job at making available and continuing to train supervisors, management, and co-workers to ask questions when needed.

Jennifer: PCM offers numerous webinars and training throughout the year to help us adjusters keep up with our continuing education credits to maintain our SIP certification. PCM also provided me with the necessary courses to be able to take my SIP exam to earn my SIP certification.

Q: What do you like about being a claims adjuster?

Dila: Fast pace, critical thinking, helping people.

Moraima: My favorite thing about being an adjuster has been the ability to be able to help injured workers understand the process when one has an injury and to make them feel confident and comfortable in asking questions and having the easiest transition back to work after they recover. As a daughter of two parents who came to this country and didn’t understand or speak the language, it gives me motivation and satisfaction when I am able to help someone like my parents who may need help translating step by step and answering all questions they may have.

Tracey: I like being able to provide guidance to my clients and injured workers. I enjoy educating the clients on ways to better serve their employees when injuries occur and working with the injured worker to get them the treatment and benefits necessary to get them well and back to work.

Michelle: As a claims adjuster, there is always something to do and something new to learn.

Q: What is one work-related accomplishment you are really proud of?

Dila: I once received a thank you card from a 76-year-old injured worker. I’m also proud of the subrogation recoveries I have received for my client.

Adam: Pacific Claims Management provides such a unique opportunity to begin a career in workers’ compensation with an expedited training program. I was the first individual to partake in this program, and I completed and passed the State of California Self-Insurance examination on my first attempt. I couldn’t have done it without my wonderful co-workers and support system at PCM.

Ryan: The account that I supervise has had a significant reduction in open claims and reserves through the work my adjusters and myself. This provides the injured workers more access to the adjusters and a better response time by the adjusters simply by having the lower caseloads.

Monica: I was able to obtain information to successfully convict a worker for workers’ compensation fraud earlier this year. It was the first conviction of fraud for me and PCM. I am also proud of helping my account get better and better each year in terms of reserves and claims closed.

Q: What makes you proud to work for Pacific Claims Management?

Moraima: It makes me proud to be working for PCM for many reasons, makes me proud to know we have scored well during different audits. It feels good knowing we all take pride in our work every day. We have amazing bosses who have really showed they care about their employees, the opportunities they provide, and the friendships created over the years here are the best. We have all grown to be close to one another and I see us like one big family.

Christina Miranda: We are given the tools to become successful and the support that management gives us not only in our work lives but also our personal lives—they are so understanding, empathic, and genuinely concerned about us. We are a true work family. I have never worked for a company that gives as much as PCM does and I don’t see myself working for any other company!

Sandy: PCM leadership takes ownership for providing a place of business for their clients that is ethical and honest—a partnership for both PCM and the client—and is loyal to their clients and employees. PCM is able to mix old school methodology with new wave technology for claims handling that complements the service provided to all clients.

Q: What does your typical day at the office look like?

Priscilla: Coffee first…then tackle daily tasks/diaries, reviewing medical reports, communicating with injured employees and clients daily, and adjusting expenses to ensure each claim is funded properly.

Moraima: My days consist of working my claim diaries, receiving calls from injured employees needing assistance or who may have different questions, setting up and working new claims, contacting doctors’ offices/attorneys, working incoming mail including request for authorizations, paying medical/legal/other bills, closing/settling claims, and deciding what we will have for lunch.

Adam: I provide claims management services for my clients to achieve the best possible outcome for both my employers and injured workers, while maintaining the integrity of California labor code ensuring all audit compliance is achieved.

Jennifer: A typical day for me is getting to the office, seeing what new claims I have, reaching out to the injured workers to see how they are doing with their injuries, and trying to get them the necessary treatment they need authorized within a timely manner to help get them back out to work.