Senior Workers Compensation Claims Examiner

Insurance Placement Solutions (IPS) has immediate openings for Workers’ Compensation Claims Adjusters with our client in California.

In this role, you’ll manage a caseload of complex indemnity workers’ compensation claims, handling files from inception through resolution while ensuring compliance with California statutes and client guidelines.

Workers’ Compensation Claims Adjuster Responsibilities

• Manage a caseload of indemnity workers’ compensation claims, including complex and litigated files
• Investigate claims to determine compensability, exposure, and benefit eligibility
• Develop and maintain action plans to drive claims toward timely resolution
• Coordinate with medical case managers to support return-to-work strategies
• Handle subrogation efforts, including identifying recovery opportunities and pursuing contributions
• Refer suspected fraud cases to SIU as appropriate
• Manage litigation, including directing defense counsel and overseeing legal strategy
• Establish, monitor, and adjust reserves in accordance with authority guidelines
• Review medical treatment and billing for appropriateness
• Maintain accurate and thorough claim documentation in compliance with California regulations
• Provide timely communication and exceptional service to claimants, clients, and stakeholders

Qualifications

• Minimum 3 years of experience managing indemnity workers’ compensation claims
• Strong knowledge of California workers’ compensation statutes and Labor Code
• Excellent analytical, organizational, and communication skills
• Ability to manage a high-volume caseload and meet deadlines in a fast-paced environment

Certification

• SIP Certification is required

Education

• Bachelor’s degree preferred or equivalent combination of education and experience

Work Arrangement

• This is a fully remote position with the possibility of becoming permanent.

About Insurance Placement Solutions

Insurance Placement Solutions is a staffing and recruiting firm specializing in the insurance industry. Our clients rely on us to quickly fill temporary, temp-to-hire, and direct hire roles while maintaining operational continuity. We provide job seekers access to exclusive opportunities with top insurance organizations that are often not advertised publicly.