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 a 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
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Responsibilities

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

1. Conducting initial contacts to gather necessary information, verify coverage, determine compensability, and develop action plans for workers' compensation claims.
2. Ensuring data integrity for workers' compensation claims.
3. Analyzing case facts to establish accurate reserves using medical and disability knowledge.
4. Collaborating with Corporate Claims to evaluate and mitigate high-exposure or catastrophic losses.
5. Providing timely and professional customer service in line with best practices.
6. Maintaining effective communication with internal and external stakeholders.
7. Evaluating and paying benefits in compliance with statutory and company guidelines.
8. Filing appropriate state forms as required.
9. Managing or coordinating medical treatment to ensure claims progress efficiently.
10. Utilizing resources to contain costs and manage exposure.
11. Reviewing and analyzing litigation issues, directing legal strategies, and preparing cases for litigation.
12. Collaborating with defense attorneys to resolve claims.
13. Conducting settlement analyses and recommending appropriate settlement values.
14. Regularly reviewing caseloads and taking proactive steps to guide claims to closure.
15. 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.

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