Workers’ Compensation Claims Examiner

Insurance Placement Solutions (IPS) has an immediate opening for a Workers’ Compensation Claims Examiner with our client. This is a fully remote opportunity for candidates located in California.

In this role, you’ll manage complex and high-exposure workers’ compensation claims involving litigation, rehabilitation, and other technical claim issues. You’ll investigate and evaluate claims, develop action plans, negotiate settlements, communicate with clients and claimants, and work toward timely and appropriate claim resolution.

Workers’ Compensation Claims Examiner Responsibilities

• Analyze and process complex or technically difficult workers’ compensation claims
• Investigate claims and gather information to determine exposure
• Develop and execute action plans to move claims toward timely and appropriate resolution
• Manage high-exposure claims involving litigation and rehabilitation
• Determine benefits due in accordance with applicable requirements
• Negotiate claim settlements within designated authority
• Identify potential subrogation and recovery opportunities
• Communicate claim activity and developments with claimants and clients
• Report applicable claims to excess carriers
• Respond to excess carrier requests and direction in a timely manner
• Ensure ongoing claim adjudication meets service expectations, industry best practices, and client requirements

Qualifications

• Minimum of 5 years of workers’ compensation claims management experience or an equivalent combination of education and experience
• Experience handling complex or technically difficult workers’ compensation claims
• Experience managing high-exposure and litigated claims
• Knowledge of workers’ compensation claims handling practices and procedures
• High school diploma or GED required

Preferred Qualifications

• Bachelor’s degree from an accredited college or university
• Professional insurance or claims certification applicable to workers’ compensation

Work Arrangement

• Fully remote opportunity
• Candidates must reside in California

About Insurance Placement Solutions

Insurance Placement Solutions is a staffing and recruiting firm specializing in the insurance industry. We connect talented professionals with temporary, temp-to-hire, and direct-hire opportunities at leading insurance organizations across the United States.