Claims Examiner - Workers Compensation | Roseville, CA
$80,000–$100,000 year
On-siteRoseville, California, United States
Job Summary
Analyze complex or technically difficult California workers' compensation claims by investigating and gathering information to determine exposure and benefits due. Manage claims through well-developed action plans to an appropriate and timely resolution, including negotiating settlements within designated authority and calculating reserve adequacy throughout the claim lifecycle. Handle high-exposure cases involving litigation and rehabilitation, ensuring ongoing adjudication meets service expectations and industry best practices. Prepare necessary state filings within statutory limits and report claims to the excess carrier while responding to direction requests professionally. This role requires five years of workers' compensation experience and knowledge of California jurisdictional requirements, with a starting salary of $80,000 - $100,000.
Required Qualifications
- California workers' compensation experience
- experience handling litigated and high-exposure claims
- understands California jurisdictional requirements
- can confidently manage claims through investigation, benefit determination, settlement negotiation, and resolution
- Five (5) years of workers compensation claims management experience or equivalent combination of education and experience
- California jurisdictional knowledge
- SIP required or must be obtained within one year of hire date
- Clear and conceptual thinking ability
- excellent judgment
- troubleshooting
- problem solving
- analysis
- discretion
- ability to handle work-related stress
- ability to handle multiple priorities simultaneously
- ability to meet deadlines
- Hearing
- vision
- talking
Desired Qualifications
- Bachelor's degree from an accredited college or university preferred
- Professional certification as applicable to line of business preferred
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.