Senior Claims Specialist – Workers' Compensation

Great American Insurance Group

. Manage California and Oregon workers' compensation claims from inception through resolution .

Posted 10/13/2026full-timeRemote • United StatesSenior💰 $105,000 - $125,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Expertise in managing workers' compensation claims with a focus on California regulations, strong negotiation skills, and the ability to analyze complex claim scenarios. Proven track record in developing strategies for favorable claim outcomes while ensuring compliance and maintaining effective communication with stakeholders.

Highest-signal resume keywords

Workers' Compensation Claims ManagementCalifornia Workers' Compensation LawsNegotiation SkillsClaims DocumentationAssociate in Claims (AIC)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AdjustingCoverage EvaluationBenefits Eligibility AnalysisClaim Reserve ManagementSettlement NegotiationClaims Trend Analysis

Soft Skills

Excellent Communication SkillsRelationship Building

Certifications & Qualifications

Associate in Claims (AIC)

Industry Keywords

Workers' CompensationCalifornia RegulationsOregon RegulationsLitigation StrategyClaim Resolution

About the role

Key responsibilities & impact

Manage California and Oregon workers' compensation claims from inception through resolution
Analyze claim facts and evaluate coverage, compensability, and benefits eligibility
Develop and execute strategies to achieve timely and favorable claim outcomes
Establish and maintain appropriate claim reserves
Negotiate settlements and bring about claim resolution
Communicate regularly with claimants, insureds, employers, and other stakeholders
Prepare and present large loss reports to internal and external audiences
Collaborate with defense counsel on litigation strategy and claim resolution
Partner with medical case managers, surveillance vendors, and other external resources
Ensure compliance with Illinois workers' compensation laws and regulations
Maintain accurate and timely claim documentation
Analyze claim trends and exposure to support effective decision-making
Provide exceptional service while building strong relationships with customers and business partners

Requirements

What you’ll need

Generally, 10+ years of workers' compensation claims adjusting experience, including complex or high-exposure claims
California experience required
Oregon experience preferred but not required
Strong knowledge of California workers' compensation laws, regulations, and claims practices
Knowledge of Oregon workers' compensation laws and claims practices is a plus
Professional industry designations such as Associate in Claims (AIC) are preferred
Ability to work Pacific Time Zone business hours
Ability to travel occasionally as needed
Excellent written and verbal communication skills
Ability to work with a variety of internal and external contacts
Must be authorized to work in the United States without the need for current or future sponsorship

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Wellness plans
Parental leave
Adoption assistance
Tuition reimbursement
Paid Time Off
Paid holidays
401(k) plan with company match
Employee stock purchase plan
Commuter benefits