Senior Claims Specialist – Workers' Compensation

This is a fully remote position, open to applicants in California, +1 more state.

📋 Description

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

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

• Create and implement strategies to achieve timely and favorable outcomes for claims.

• Set and maintain appropriate reserves for claims.

• Negotiate settlements and facilitate claim resolutions.

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

• Prepare and deliver comprehensive reports on large losses to both internal and external parties.

• Work alongside defense counsel to develop litigation strategies and resolve claims.

• Collaborate with medical case managers, surveillance vendors, and other external resources.

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

• Keep precise and up-to-date documentation for all claims.

• Analyze claim trends and exposure to aid in informed decision-making.

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

⛳️ Requirements

• At least 10 years of experience in workers' compensation claims adjusting, particularly with complex or high-exposure claims.

• Experience in California is mandatory.

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

• Familiarity with Oregon's workers' compensation laws and claims practices is advantageous.

• Preferred qualifications include 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 possess authorization to work in the United States without the need for current or future 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