Senior Claims Specialist – Workers' Compensation

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

📋 Description

• Oversee California workers' compensation claims from initiation to resolution.

• Assess claim details and evaluate coverage, compensability, and eligibility for benefits.

• Formulate and implement strategies to achieve prompt and favorable outcomes for claims.

• Set and maintain appropriate reserves for claims.

• Negotiate settlements to facilitate claim resolution.

• Maintain regular communication with claimants, insured parties, employers, and other relevant stakeholders.

• Prepare and deliver large loss reports to both internal and external audiences.

• Collaborate with defense attorneys on litigation strategies and claim settlements.

• Work in partnership with medical case managers, surveillance vendors, and other external resources.

• Ensure adherence to California workers' compensation laws and regulations.

• Keep accurate and timely documentation of claims.

• Analyze claim trends and exposures to inform effective decision-making.

• Deliver exceptional service while fostering strong relationships with customers and business partners.

⛳️ Requirements

• A minimum of 10 years of experience in workers' compensation claims adjusting, specifically in complex or high-exposure cases.

• Experience in California is mandatory.

• In-depth knowledge of California workers' compensation laws, regulations, and claims practices.

• Preferred professional industry designations, such as Associate in Claims (AIC).

• Availability to work during Pacific Time Zone business hours.

• Willingness to travel occasionally as required.

• Excellent written and verbal communication skills.

• Ability to collaborate with a diverse range of internal and external contacts.

• Must have authorization to work in the United States without the need for 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.