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.

ID: 006Uw00000ezfC5

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