Senior Workers' Compensation Adjuster

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

📋 Description

• Oversee moderate to complex workers’ compensation claims from the initial investigation through to resolution.

• Conduct interviews with insured parties, claimants, witnesses, and other pertinent individuals to evaluate claim eligibility.

• Gather statements; analyze coverage; assess compensability and applicable benefits; establish appropriate reserves.

• Negotiate settlements and manage litigation processes.

• Handle a diverse range of claims with settlement authority up to $175,000.

• Provide mentorship or support to junior team members in their claims processing.

• Ensure timely and accurate documentation of claim files in accordance with company standards.

• Coordinate medical management, including Utilization Review (UR) and Independent Medical Review (IMR) along with return-to-work strategies.

• Engage in claim reviews and case discussions.

⛳️ Requirements

• Over 5 years of experience in California workers’ compensation claims.

• Current Experienced Adjuster Designation required.

• Bachelor's degree is preferred.

• Experience in adjusting complex indemnity and litigated claims.

• Advanced understanding of California workers’ compensation regulations and laws.

• Capability to work independently and effectively in a remote setting.

• Outstanding analytical and problem-solving skills.

• Strong verbal and written communication abilities.

• Proficient negotiation skills in challenging scenarios.

• Excellent organizational and time management skills with the ability to prioritize competing demands.

• Proficient in Microsoft Word, Excel, and Outlook.

• Ability to perform advanced mathematical calculations.

🏝️ Benefits

• Competitive base salary along with incentive plans for eligible team members.

• 401(K) retirement plan featuring a company match of up to 6% of your eligible salary.

• Complimentary basic life and AD&D insurance, along with long-term and short-term disability insurance.

• Comprehensive medical, dental, and vision plans tailored to meet your healthcare needs.

• Wellness incentives.

• Generous time-off program that encompasses personal, holiday, and volunteer paid time off.

• Flexible work schedules and hybrid/remote options for qualifying positions.

• Educational assistance.