Our client, an A-rated Insurance Carrier, is seeking to add an experienced California Workers' Compensation Claims Specialist to join their team in a fully remote capacity (must reside in the state of California). This person will be responsible for managing moderate to complex California Workers' Compensation Lost Time claims from inception to closure, ensuring that all claims are handled efficiently and in accordance with California Workers' Compensation law.
Key Responsibilities:
- Manage a caseload of 100 – 120 California Workers' Compensation Lost Time claims, ranging from moderate to complex severity.
- Conduct thorough investigations by liaising with agents, insureds, claimants, witnesses, and other relevant parties.
- Administer benefits for medical treatment and handle medical billing associated with Workers' Compensation claims.
- Negotiate settlements with injured workers and attorneys to reach fair and timely resolutions.
- Actively manage files, ensuring timely and accurate reserving practices.
- Present serious claims to committees and oversee the management of litigated files.
- Participate in ongoing training and development to stay current with industry practices and regulations.
- Set or recommend appropriate reserves based on investigative findings.
Qualifications:
- 5 - 9+ years of experience in handling California Workers' Compensation Lost Time claims.
- Strong knowledge of California Workers' Compensation law is required.
- Experience with medical treatment claims and medical billing processes within Workers' Compensation.
- Active CA Self-Insurance Plan (SIP) License is mandatory.
- Bachelor’s degree preferred, though not required.
What’s in it for you:
- Competitive base salary of $95,000 to $115,000 annually + lucrative bonus
- Fully remote work environment offering flexibility.
- Comprehensive benefits package, including Medical, Dental, Vision, and Life insurance plans.
- Employer-matched 401(k) retirement plan.
- Lucrative PTO plan.
