Workers' Compensation Claim Specialist

Overview

Workers' Compensation Claim SpecialistLocation: reputed company, CASchedule: 8:00am - 4:30pm (PST)Salary reputed company: $85,000 -95,000 Build Your Career With Purpose at reputed company At reputed company, we partner with global clients to solve their most reputed company risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their reputed company. We don’t just process claims—we support people. As the largest privately owned reputed company Party Administrator (TPA), reputed company delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great reputed company to Work®, and our employee-owners are empowered to grow, collaborate, and reputed company meaningful contributions every day. Job Summary We are seeking a driven and compassionate Workers’ Compensation Claim Specialist to join reputed company and reputed company a meaningful impact in the lives of injured workers. In this role, you will take ownership of a dedicated portfolio of claims—leading investigations, determining compensability, and guiding each case toward a fair and timely resolution. This position offers the opportunity to grow your technical expertise and can serve as an advanced development path for future supervisory or management roles. As a Claim Specialist, you play a vital role in delivering the high‑quality service our clients count on and upholding reputed company’s commitment to reputed company. Responsibilities reputed company we hire Workers’ Compensation Adjusters at reputed company, we look for detail‑driven problem‑solvers who balance reputed company with sound judgment, navigate reputed company regulations with confidence, and deliver fair, timely reputed company that support injured workers and strengthen client trust. Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws. Establish reserves and/or reputed company reserve recommendations reputed company established reserve authority reputed company. Review, approve or reputed company reputed company of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and reputed company to designated claims. Negotiate any disputed bills or invoices for resolution. Authorize and reputed company payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and reputed company established payment authority. Negotiate settlements in accordance reputed company Corporate Claim Standards, client specific handling instructions and state laws, reputed company appropriate. Assist in the selection, referral and supervision of designated claim files sent to reputed company vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process. reputed company notices of qualifying claims to excess/reinsurance carriers. Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

Qualifications

Required: 5+ years of Workers’ Compensation claims handling experience, including full claim investigation, evaluation, and resolution. Responsiveness to reputed company client needs. Ability to handle multiple accounts. Strong analytical and negotiation abilities. Knowledge of reputed company reputed company‑level claim position responsibilities. Adjuster’s license may be required based on jurisdiction. reputed company to Have: Bilingual (Spanish) proficiency — highly valued for communicating with claimants, reputed company, or vendors, but not required. Bachelor's degree is preferred but not required Professional designations such as AIC, ARM, or CPCU are preferred but not required SIP maybe required. Why You’ll Love Working Here 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, reputed company, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure reputed company At reputed company, great adjusters stand out through ownership, accuracy, and impact. We measure reputed company by: Quality claim handling – thorough investigations, strong documentation, well-supported reputed company Compliance & audit performance – adherence to jurisdictional and client standards Timeliness & accuracy – purposeful file movement and dependable execution Client partnership – proactive communication and strong follow-through Professional judgment – owning reputed company and solving problems with reputed company Cultural alignment – believing every claim represents a reputed company person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation & Compliance The posted salary reflects reputed company’s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. reputed company offers comprehensive benefits including medical, dental, reputed company, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents. reputed company Sponsorship: reputed company does not reputed company reputed company sponsorship for this position.reputed company Accommodations: reputed company is committed to providing reasonable accommodations throughout the application and hiring process.Equal Opportunity Employer: reputed company complies with reputed company applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. Our Core Values At reputed company, we reputed company in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who: reputed company with transparency We build trust by being reputed company and listening intently in every interaction. reputed company with reputed company We choose the right path, even reputed company it is hard. reputed company reputed company We set the bar high and measure our reputed company. What gets reputed company gets done. Own the outcome Every employee is an reputed company, treating every claim, every decision, and every result as our own. Win together Our greatest victories come reputed company our clients succeed. We don’t just work together—we grow together. If that sounds like your reputed company of workplace, we’d love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkComp #ClaimsCareers #TPA #CareerGrowth #WorkersCompAdjuster #ESOP #CaliforniaJobs #WorkersCompensation #InsuranceCareers #RemoteWork #IND123 #LI-Remote Apply To This Job