Senior Workers Comp Claims Specialist

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

📋 Description

• Oversee a substantial inventory of intricate claims to assess compensability and liability.

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

• Evaluate and negotiate claim settlements and reserves within designated authority limits.

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

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

• Approve payments within assigned authority thresholds and ensure prompt disbursement.

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

• May mentor staff and engage in talent acquisition, development, and performance evaluation processes.

• Execute additional responsibilities as assigned.

⛳️ Requirements

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

• Typically, a minimum of 13 years of experience in handling property and casualty claims.

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

• Experience with CA Work Comp is preferred.

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

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

• Familiarity with industry laws and regulations.

• Advanced skills in organizing and prioritizing caseloads.

• Outstanding interpersonal and communication abilities.

• Capability to foster relationships and lead negotiations.

• Proven capacity to manage confidential information with discretion.

• Acknowledged as a subject matter expert within the organization, potentially functioning at a peer level to management.

• Candidates must be authorized to work in the United States without the necessity 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.