Workers’ Compensation Claims Examiner

Insurance Placement Solutions (IPS) has an immediate opening for a Workers’ Compensation Claims Examiner with our client. This is a direct-hire hybrid opportunity based in Sacramento, CA. The position requires working in the office two days per week.

In this role, you’ll manage complex California workers’ compensation indemnity claims from inception through resolution, including investigation, litigation management, medical coordination, reserving, and settlement negotiations. The ideal candidate will have extensive California lost-time claims handling experience and the ability to independently handle technically complex files.

Workers’ Compensation Claims Examiner III Responsibilities

• Manage a caseload of complex California workers’ compensation indemnity claims from inception through resolution.
• Investigate claims and gather information to determine compensability, exposure, and appropriate claim strategy.
• Evaluate medical treatment, disability benefits, and claim exposure in accordance with California workers’ compensation regulations.
• Manage litigated claims, including coordination with defense counsel and oversight of litigation strategy.
• Establish, monitor, and adjust reserves throughout the life of the claim.
• Negotiate settlements within assigned authority while achieving timely and appropriate resolutions.
• Maintain accurate claim documentation and ensure files are handled in compliance with company guidelines and client requirements.
• Coordinate with medical providers, vendors, attorneys, and other stakeholders to move claims toward resolution.
• Identify subrogation opportunities and manage claim recoveries when applicable.
• Communicate claim activity, recommendations, and status updates with clients and internal partners.

Qualifications

• Minimum of 5 years of California workers’ compensation lost-time/indemnity claims experience.
• Experience handling complex workers’ compensation claims involving litigation.
• SIP certification required.
• Strong knowledge of California workers’ compensation laws, regulations, and claim handling practices.
• Experience managing indemnity claims independently from investigation through resolution.
• Ability to manage a complex caseload while meeting deadlines and service expectations.

Work Arrangement

• Hybrid opportunity based in Sacramento, CA.
• Requires working in the office two days per week.
• Direct-hire position.

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.