We are seeking a Senior Workers’ Compensation Claims Adjuster with a minimum of five years of lost time claims experience handling California workers’ compensation cases.
The ideal candidate will have a deep understanding of California workers' compensation laws and regulations, including thorough knowledge of the Labor Code, case law, and related statutes.
MUST COME FROM AN INSURANCE INDUSTRY BACKGROUND & not HEALTH INSURANCE
THIS IS A MUST : Experience in Continuous trauma.
Must be certified in CA
Position is Remote
Duration : 3+ months (Position is 100% remote, but prefers no one from EST. The closer to PST the better, but doesn’t have to be PST at all.
Will need to work PST hours though)
Rate : $40-$50 / hr DOE.
Key Responsibilities :
- Manage and adjust complex lost time workers’ compensation claims from inception to closure, ensuring compliance with state regulations.
- Conduct thorough investigations, assess liability, and make appropriate claims determinations.
- Coordinate medical care, rehabilitation, and return-to-work strategies for injured employees.
- Handle settlement negotiations, including preparing and presenting cases for hearings and trials, if necessary.
- Work closely with internal legal counsel, claims managers, and third-party administrators (TPAs) to ensure claims are handled efficiently and in line with company policies.
Qualifications :
- Minimum of five years of experience handling lost time claims in California.
- Experience in Continuous trauma.
- Candidates will be working on old claims filling
- Proven ability to handle complex claims and maintain a high level of accuracy and detail.
- Strong negotiation skills, with the ability to effectively resolve claims while minimizing costs.
- Familiarity with California state reporting requirements and the ability to manage claims within legal timelines.
- Excellent communication skills, both verbal and written, for interacting with claimants, attorneys, and healthcare providers.
- CA does not have licenses, but person must be certified in CA
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