Senior Workers’ Compensation Claims Examiner

Insurance Placement Solutions (IPS) has an immediate opening for a Senior Workers’ Compensation Claims Examiner with our client. This is a fully remote temporary opportunity handling California workers’ compensation claims and supporting Pacific Time business hours.

In this role, you’ll independently manage complex California workers’ compensation claims, including investigation, coverage and compensability decisions, litigation management, reserving, settlements, and recovery opportunities. You’ll manage claims through resolution while maintaining accurate documentation and communicating claim activity to clients, carriers, and other stakeholders.

Senior Workers’ Compensation Claims Examiner Responsibilities

• Manage complex California workers’ compensation claims from investigation through resolution
• Investigate claims and evaluate compensability, coverage, and claim exposure
• Develop and maintain claim strategies and action plans
• Direct discovery and litigation strategy in collaboration with legal counsel
• Establish and maintain appropriate reserves based on claim exposure
• Authorize claim payments within designated authority
• Evaluate and negotiate settlements within designated authority
• Identify and pursue subrogation and third-party recovery opportunities
• Analyze claim activity and prepare reports for clients, carriers, and management
• Participate in claim reviews and provide analysis of claim developments
• Maintain accurate and timely claim documentation
• Ensure claims are handled in accordance with California workers’ compensation requirements and client expectations

Qualifications

• Experience independently handling California workers’ compensation claims
• Experience managing complex workers’ compensation claims
• Experience handling litigated claims
• Experience with claims investigation, reserving, settlement negotiation, and resolution

Preferred

• California Self-Insured Plans (SIP) certificate

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.