Workers' Compensation Claims Representative

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

📋 Description

• Assess compensability and/or coverage matters for workers' compensation claims involving lost time.

• Efficiently oversee a portfolio of lost time claims across various jurisdictions.

• Negotiate and facilitate settlements subject to management's oversight.

• Collect medical and factual information to evaluate compensability.

• Coordinate external investigations and manage litigation files within authorized limits.

• Maintain ongoing communication with claimants and/or their legal representatives, outside investigators, and rehabilitation specialists.

• Keep regular contact with insured parties, account representatives, and medical providers.

⛳️ Requirements

• Claims Adjuster Designation or SIP Certification is mandatory.

• A minimum of 3 years of relevant experience is required.

• Experience in managing claims in California is essential.

• A Bachelor's degree is a prerequisite.

• Previous experience with an insurance carrier is preferred.

• Experience in handling lost time or litigated claims is necessary.

• Familiarity with medical terminology is a must.

• Strong skills in organization, problem-solving, negotiation, and conflict resolution are required.

• Exceptional verbal and written communication abilities are essential.

🏝️ Benefits

• Medical (PPO/HDHP), vision, disability, and life insurance options.

• Enhanced dental plan incorporating orthodontia coverage alongside a standard plan.

• Generous paid time off (PTO) policy for all eligible employees.

• Paid company holidays plus 4 floating holidays.

• Paid parental leave benefits.

• Employee Retirement Savings Plan/401(k) with company matching and immediate vesting.

• Education Assistance Program offering 100% upfront tuition reimbursement after 6 months of service for approved degree programs.

• Service Recognition Program providing a monetary award for a vacation every 5 years of employment.

• Wellness initiatives, including Fitness Center and Weight Watchers Reimbursement programs.

• Optional accident, critical illness, and hospital indemnity benefits.

• Employee discount and rewards program on travel, tickets, electronics, home, and more.