Workers Compensation Claims Adjuster II

Intercare Holdings Insurance Services

. Manage assigned claim files through conclusion in accordance with applicable statutes, company rules, service contracts, and performance objectives .

Posted 11/3/2026full-timeGlendale • California • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing indemnity claims, ensuring compliance with applicable statutes and company guidelines, while effectively collaborating with medical case managers and handling litigation processes. Proficient in gathering and analyzing evidence, establishing monetary case reserves, and maintaining timely communication with stakeholders.

Highest-signal resume keywords

Indemnity Claims ManagementCalifornia Labor Code KnowledgeLitigation ManagementEvidence Gathering and AnalysisMonetary Case Reserves Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ResolutionCompensability KnowledgeDisability Payments ManagementMedical Bill ReviewVocational Rehabilitation PlansSubrogation PursuitFraud Case ReferralThree-Point Contact ExecutionPerformance Objectives AdherenceCase File Management

Soft Skills

Problem-SolvingCustomer ServiceInterpersonal SkillsTeamworkCommunication

Certifications & Qualifications

Bachelor's DegreeSIP Certificate

Industry Keywords

Workers Compensation ClaimsClaims Costs ReductionReturn-to-Work PotentialClaim File ComplianceService Contracts

About the role

Key responsibilities & impact

Manage assigned claim files through conclusion in accordance with applicable statutes, company rules, service contracts, and performance objectives
Perform three-point contact on all new losses within 24 hours with the claimant, employer, and treating physician
Gather evidence and relevant information regarding case facts, compensability, disability payments, vendors, medical and expense payments, and reasons claims remain open
Maintain current plans of action for assigned indemnity claims
Partner with the medical case manager to maximize early return-to-work potential and reduce extended disability payments, vocational rehabilitation, and other claims costs
Refer suspected fraud cases to the SIU
Pursue subrogation, contributions on multiple-defendant cases, and apportionment for pre-existing disability
Handle claim files in compliance with applicable statutes, service contracts, and company guidelines
Review and approve vocational rehabilitation plans
Establish, monitor, and adjust monetary case reserves
Review medical bills before referral to InterMed for payment and claim-file posting
Respond to telephone messages and inquiries within 24 hours and written inquiries within one week
Direct, manage, and control the litigation process
Perform other duties assigned by the Supervisor or Manager
Report directly to the unit Claims Supervisor

Requirements

What you’ll need

Bachelor’s degree (B.A.) or equivalent from a four-year college, or 3–5 years related experience and training, or 5 years without a SIP certificate, or equivalent combination of education and experience
Working knowledge of the Labor Code of the State of California as it pertains to workers compensation claims and the legal requirements for handling them
Ability to manage assigned indemnity claim files through resolution
Ability to perform three-point contact with the claimant, employer, and treating physician within 24 hours of receiving a claim
Ability to gather and analyze evidence and claim information
Knowledge of compensability, disability payments, vendors, medical and expense payments, and claim resolution
Ability to establish, monitor, and adjust monetary case reserves within assigned authority levels
Ability to review medical bills for appropriateness
Litigation management capabilities
Problem-solving, customer service, interpersonal, and teamwork competencies
Ability to perform all essential duties satisfactorily
Ability to meet response timelines for telephone and written inquiries

Benefits

Comp & perks

Comprehensive medical, dental, and vision benefits
Company contributions to HSA and FSA plans
Employer paid life and disability insurance
401(k) with company match
Paid time off (PTO) and company paid holidays
Learning and development opportunities that support real career advancement
Employee assistance resources and a supportive culture that values balance and wellbeing