Workers Compensation Claims Examiner

Insurance Placement Solutions (IPS) has an immediate opening for a Workers’ Compensation Claims Examiner with our client. This opportunity focuses on complex California workers’ compensation claims and offers remote flexibility. Candidates who are able to work in an office or on a hybrid schedule are preferred, but onsite attendance is not required.

In this role, you’ll manage complex and high-exposure California workers’ compensation claims from investigation through resolution. You’ll evaluate claim exposure, administer benefits, establish reserves, manage litigation, negotiate settlements, and ensure claims are handled in accordance with California requirements and client expectations.

Workers’ Compensation Claims Examiner Responsibilities

• Manage complex California workers’ compensation claims from investigation through resolution
• Investigate claims and gather information to determine compensability and exposure
• Develop and maintain effective claim strategies and action plans
• Manage high-exposure claims involving litigation and rehabilitation
• Establish appropriate reserves and monitor reserve adequacy throughout the life of the claim
• Calculate and administer workers’ compensation benefits and authorize claim payments
• Negotiate settlements within designated authority
• Manage the litigation process and work toward timely, cost-effective claim resolution
• Prepare required state filings within statutory timeframes
• Identify and pursue potential subrogation opportunities
• Report applicable claims to excess carriers and respond to requests for information and direction
• Maintain accurate and timely claim documentation
• Ensure claims are handled in accordance with California workers’ compensation requirements and client service expectations

Qualifications

• Minimum of 4 years of California workers’ compensation claims handling experience
• Experience independently managing complex or high-exposure workers’ compensation claims
• Experience managing litigated California workers’ compensation claims

Preferred

• Bachelor’s degree from an accredited college or university

Licensing & Certifications

• Professional certification and/or adjuster licensing as applicable to the assigned claims

Work Arrangement

• Remote work available
• In-office or hybrid candidates preferred, but not required

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.

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