Workers' Compensation Claim Consultant
$80,000–$95,000 year
RemoteCalifornia, United States
Job Summary
Investigate, evaluate, and adjust Workers' Compensation claims in compliance with company standards and applicable laws, including establishing reserves and negotiating medical, legal, and damage expenses. Authorize claim payments and settlements within established authority guidelines while coordinating external vendors such as legal counsel and surveillance providers. Monitor claim progression, manage subrogation opportunities, and calculate disability rates to ensure regulatory compliance. Handle complex, mostly litigated claims independently with minimal supervision, participating in hearings, mediations, and client meetings as appropriate. Maintain timely communication with stakeholders and provide status updates and reserve analyses. This full life-cycle adjuster position supports injured workers and strengthens client trust within a certified Great Place to Work® TPA environment.
Required Qualifications
- 5+ years of California Workers' Compensation claims experience
- Proficiency with Microsoft Office products, including Word, Excel, and Outlook
- SIP is required, or you must be able to obtain
- Experience handling a mostly litigated workload
Desired Qualifications
- Bachelor's degree is preferred but not required
- Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required
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