Workers Compensation Claims Examiner

Insurance Placement Solutions (IPS) has an immediate opening for a Remote Workers’ Compensation Claims Adjuster for our client in California. In this remote role, you’ll be an essential member of our client’s claims team, using your expertise in workers’ compensation to independently investigate, evaluate, and resolve lost-time claims. You’ll manage claims in accordance with applicable legal statutes, policy terms, and internal guidelines.

Workers’ Compensation Lost Time Claims Adjuster Responsibilities

• Manage a caseload of approximately 130–180 California workers’ compensation files, including complex claims
• Investigate claims in a timely manner and determine compensability based on California law
• Administer indemnity and medical benefits in accordance with statutory regulations and company guidelines
• Manage medical treatment and medical billing, authorizing care as appropriate
• Set and maintain appropriate reserves within company guidelines
• Refer cases to outside defense counsel as needed and monitor litigation
• Communicate with claimants, medical providers, vendors, and clients regarding claim status and issues
• Maintain diary systems and accurate file documentation reflecting current claim activity
• Finalize and settle claims within designated authority levels
• Partner with loss control staff when appropriate
• Participate in file reviews and adhere to all company policies and procedures

Qualifications

• 3+ years of experience handling lost-time/indemnity claims as a workers’ compensation claims adjuster
• Strong knowledge of California workers’ compensation statutes and medical terminology

Certification

• CA SIP Certification is required

Education

• A high school diploma or equivalent is required
• Bachelor’s degree preferred or equivalent combination of education and experience

About Insurance Placement Solutions

Insurance Placement Solutions is a staffing and recruiting firm specializing in the insurance industry, including workers’ compensation claims positions in Fresno, CA. Our clients rely on us to quickly fill critical openings—temporary, temp-to-hire, and direct hire—while maintaining continuity. We provide job seekers with access to exclusive opportunities at top-tier insurance companies that are often not advertised publicly.