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California Workers' Claims Specialist | Fully Remote

Work from home Full-time role Hiring

Position: California Workers' Compensation Claims Specialist | Fully Remote Location: Winona Lake Our client is seeking to add a Senior Workers Compensation Claims Specialist to their remote team. This role will consist of handling moderate to complex California Workers Compensation Lost Time claims from inception to close. Qualified candidates must possess a strong knowledge in California Workers' Compensation claims law and have the ability to work-from-home.

  • Handle a pending of 90 - 105 moderate to complex California Workers Compensation lost time claims.
  • Research and formulate a basis on which coverage decisions will be made, conduct thorough investigations, manage medical treatment, influence early full return-to-work, guide litigation and control claim outcomes.
  • Negotiate settlements with injured workers and attorneys.
  • Responsibilities also include active file management, effective reserving practices, participation in training activities, presentation of serious claims to committee and supervision of litigated files.
  • Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
  • Consistently exhibit a high level of customer service and adherence to department Best Practices.

Requirements

  • 3 - 7+ years of Workers Compensation Lost Time claims handling experience
  • Must be well versed in California Workers’ Compensation Law
  • Must have experience handling litigated files
  • Excellent Customer Service and Organizational skills.
  • High School Diploma;

Bachelor's Degree preferred but not required. Salary/Benefits

  • $95,000 - $110,000 annual base salary plus bonus (depending on experience)
  • Competitive Medical, Dental, Vision and Life plans
  • Medical benefits effective on 1st day of employment

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