New Job Opening: Senior CA Workers Compensation Claims Adjuster - Remote in Reno, NV

Job Description

Senior Workers Compensation Claims Adjuster

Job Summary

We are seeking a highly skilled and experienced Senior Workers Compensation Claims Adjuster to join a team. The ideal candidate will bring extensive expertise in handling Workers Compensation Indemnity Claims, possess strong analytical skills, and demonstrate a proactive approach to claims management. This role is critical to our mission of delivering exceptional service and support to clients.

Compensation Package

We offer a competitive compensation package, including:

• Salary Range:
  
  
  
  • Level I: $90,000 - $105,000/year
  
  
  • Level II: $110,000 - $120,000/year
  
  
  
  


• Competitive benefits package, 401(k), paid time off, professional development opportunities, etc.

Responsibilities

As a Senior Workers Compensation Claims Adjuster, your key responsibilities will include:

• Conducting initial contacts to gather necessary information, verify coverage, determine compensability, and develop action plans for workers' compensation claims.


• Ensuring data integrity for workers' compensation claims.


• Analyzing case facts to establish accurate reserves using medical and disability knowledge.


• Collaborating with Corporate Claims to evaluate and mitigate high-exposure or catastrophic losses.


• Providing timely and professional customer service in line with best practices.


• Maintaining effective communication with internal and external stakeholders.


• Evaluating and paying benefits in compliance with statutory and company guidelines.


• Filing appropriate state forms as required.


• Managing or coordinating medical treatment to ensure claims progress efficiently.


• Utilizing resources to contain costs and manage exposure.


• Reviewing and analyzing litigation issues, directing legal strategies, and preparing cases for litigation.


• Collaborating with defense attorneys to resolve claims.


• Conducting settlement analyses and recommending appropriate settlement values.


• Regularly reviewing caseloads and taking proactive steps to guide claims to closure.


• Mentoring team members and serving as a Subject Matter Expert for legal, jurisdictional, and company needs.

Qualifications/Requirements

To be successful in this role, you must meet the following requirements:

• A minimum of 6+ years of experience handling California Workers Compensation Indemnity Claims.


• SIP license is a plus; if not currently held, must be willing to obtain it within six months of hire.


• Stable work history with no frequent job changes.


• Experience with litigation and legal strategy.


• Prior experience working with an insurance carrier.

#LI-MW1