Senior CA Workers Compensation Claims Adjuster

Senior Workers Compensation Claims Adjuster

We are seeking a highly skilled and experienced Senior Workers Compensation Claims Adjuster to join a team. The ideal candidate will bring extensive expertise in handling Workers Compensation Indemnity Claims possess strong analytical skills and demonstrate a proactive approach to claims management. This role is critical to our mission of delivering exceptional service and support to clients.

We offer a competitive compensation package including:

• Salary Range:
  • Level I: $90000 - $105000/year
  • Level II: $110000 - $120000/year
• Competitive benefits package 401(k) paid time off professional development opportunities etc.

As a Senior Workers Compensation Claims Adjuster your key responsibilities will include:

• Conducting initial contacts to gather necessary information verify coverage determine compensability and develop action plans for workers compensation claims.
• Ensuring data integrity for workers compensation claims.
• Analyzing case facts to establish accurate reserves using medical and disability knowledge.
• Collaborating with Corporate Claims to evaluate and mitigate high-exposure or catastrophic losses.
• Providing timely and professional customer service in line with best practices.
• Maintaining effective communication with internal and external stakeholders.
• Evaluating and paying benefits in compliance with statutory and company guidelines.
• Filing appropriate state forms as required.
• Managing or coordinating medical treatment to ensure claims progress efficiently.
• Utilizing resources to contain costs and manage exposure.
• Reviewing and analyzing litigation issues directing legal strategies and preparing cases for litigation.
• Collaborating with defense attorneys to resolve claims.
• Conducting settlement analyses and recommending appropriate settlement values.
• Regularly reviewing caseloads and taking proactive steps to guide claims to closure.
• Mentoring team members and serving as a Subject Matter Expert for legal jurisdictional and company needs.

To be successful in this role you must meet the following requirements:

• A minimum of 6 years of experience handling California Workers Compensation Indemnity Claims.
• SIP license is a plus; if not currently held must be willing to obtain it within six months of hire.
• Stable work history with no frequent job changes.
• Experience with litigation and legal strategy.
• Prior experience working with an insurance carrier.

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