CA - Senior Claims Adjuster, Worker's Compensation
Core
Manage the full lifecycle of high-dollar, complex workers' compensation claims, including investigation, reserve setting, litigation management, and settlement negotiation to mitigate exposure and ensure favorable outcomes.
Role type
Senior Claims Adjuster (Workers' Compensation)
Builds
Favorable claim outcomes and efficient claim file management for small business customers
Domain
Insurance / Workers' Compensation
Deliverable
client delivery
Required skills
Workers' compensation claim adjusting, 3-point contact investigation, reserve setting, litigation management, settlement negotiation, statutory compliance, claim adjudication, medical benefits administration, legal fee management
Preferred skills
Carrier background, California WC claims experience, G-Suite tools, Slack, mentoring junior adjusters
Technologies
G-Suite, Slack
Responsibilities
Independently handle all aspects of workers' compensation claims from set-up to closure; Evaluate and handle high dollar, high exposure, complex claims; Conduct timely 3-point contact investigation; Mitigate complex exposure while achieving the best outcome; Determine timely and accurate compensability decisions; Set and adjust timely/accurate reserves; Control legal activity with defense counsel; Negotiate settlement; Serve as a point of contact for agents and customers; Advocate for leading claims customer experience; Continuously improve claims operations and processes
Seniority
Senior, hands-on IC
