Senior Claims Specialist, Workers Comp CA

This is a fully remote position, open to applicants in Nebraska.

📋 Description

• Oversee a substantial inventory of intricate workers’ compensation claims while assessing compensability and liability.

• Direct thorough claims investigations to verify coverage and ascertain liability, compensability, and damages.

• Evaluate and negotiate settlement amounts and reserves within established authority.

• Participate in arbitrations, mediations, depositions, or trials as required.

• Communicate complex coverage and settlement details to insured individuals, claimants, and external stakeholders.

• Approve payments within designated authority limits and ensure timely distribution.

• Keep precise and comprehensive claim files, including correspondence, reports, and settlement agreements.

• Potentially mentor staff and engage in talent selection, development, and performance management processes.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field, or equivalent experience.

• At least 13 years of experience in managing property and casualty claims.

• Completion of or ongoing progress towards a professional designation such as Associate in Claims (AIC) is preferred.

• Experience with California workers’ compensation is preferred.

• Proven ability to handle assignments at the highest authority limits and complex technical levels.

• Strong analytical, negotiation, and problem-solving abilities.

• In-depth knowledge of insurance policies, coverage, and claims handling protocols.

• Familiarity with industry laws and regulations.

• Advanced skills in organizing and prioritizing caseloads for efficient claim resolutions.

• Exceptional interpersonal and communication abilities, including relationship management and negotiation leadership.

• Capability to manage confidential information with the utmost discretion.

• Must be authorized to work in the United States without current or future employment visa sponsorship.

🏝️ Benefits

• Medical coverage

• Dental coverage

• Vision coverage

• Wellness plans

• Parental leave

• Adoption assistance

• Tuition reimbursement

• Paid Time Off

• Paid holidays

• 401(k) plan with company match

• Employee stock purchase plan

• Commuter benefits