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 established standards and California law, with a focus on complex indemnity cases involving traveling employees and variable wage structures. Independently manage full life-cycle claims, including calculating Average Weekly Wage (AWW) for stipends and per diem, establishing reserves, and negotiating settlements within corporate standards. Review medical, legal, and invoice documents to determine reasonableness, authorize payments, and maintain accurate personal diaries and status reports. Assist in selecting outside vendors and attend hearings, mediations, and WCAB proceedings as needed. This full-time role offers a development pathway into senior positions within CCMSI's TPA environment.
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
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