California Workers' Compensation Insurance Adjuster
$80,000–$98,000 year
RemoteCalifornia, United States
Job Summary
Investigate, evaluate, and adjust Workers' Compensation claims in accordance with California law, including complex indemnity cases involving traveling employees and variable wage structures. Independently manage wage calculations and document Average Weekly Wage (AWW) analysis for stipends, per diem, and living allowances. Establish reserves, review medical and legal invoices, negotiate settlements, and authorize claim payments within established authority levels. Assist in selecting outside vendors, monitor subrogation claims, and attend hearings or mediations as needed. Maintain accurate claim diaries, prepare status reports, and communicate effectively with clients, claimants, and vendors throughout the lifecycle.
Required Qualifications
- Five (5) or more years of California Workers' Compensation claims experience, managing full life-cycle claims.
- Demonstrated experience handling complex indemnity claims with minimal supervision.
- Hands-on experience calculating California AWW, including claims involving stipends, per diem, or other non-traditional wage components.
- Strong understanding of California Labor Code and WC regulations related to wage determination and benefit calculations.
- Ability to independently evaluate and defend wage determinations when disputed.
- Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
- Adjuster license as required by jurisdiction; California SIP preferred or ability to obtain within the first year of employment.
Desired Qualifications
- Experience handling claims involving traveling or multi-location employees.
- Prior experience in a TPA environment.
- Bachelor's degree preferred but not required.
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, and vendors.
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.