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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in California workers' compensation claims management, including investigation, negotiation, and litigation processes. Proficient in calculating reserves, preparing state filings, and managing claims to ensure timely and appropriate resolutions.
Highest-signal resume keywords
California Workers' Compensation Claims ExperienceLitigated Claims ManagementReserve Calculation and AssignmentSIP CertificationCalifornia Jurisdictional Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims InvestigationSettlement NegotiationClaims ResolutionBenefit CalculationState Filings PreparationLitigation ManagementClaims ReportingSubrogation Claims IdentificationClaims Payment ProcessingReserve Adequacy Management
Soft Skills
Clear ThinkingExcellent JudgmentProblem SolvingDiscretionStress Management
Tools & Technologies
Computer Keyboarding
Certifications & Qualifications
SIP CertificationProfessional Certification
Industry Keywords
California Workers' CompensationClaims ManagementHigh-Exposure ClaimsStatutory LimitsExcess Carrier Reporting
About the role
Key responsibilities & impact- Analyze and process complex or technically difficult California workers' compensation claims
- Investigate claims and gather information to determine claim exposure
- Manage claims through action plans to timely and appropriate resolution
- Negotiate claim settlements within designated authority
- Calculate and assign timely and appropriate reserves
- Manage reserve adequacy throughout the life of claims
- Calculate and pay benefits due
- Approve and make timely claim payments and adjustments
- Settle claims within designated authority level
- Prepare necessary state filings within statutory limits
- Manage litigation processes for timely and cost-effective claims resolution
- Report claims to the excess carrier
- Respond to requests for direction professionally and promptly
- Identify subrogation claims and negotiate settlements
Requirements
What you’ll need- California workers' compensation claims experience
- Experience handling litigated and high-exposure claims
- Four (4) years of California workers compensation claims management experience or equivalent combination of education and experience required
- California jurisdictional knowledge required
- SIP required or must be obtained within one year of hire date
- Bachelor's degree from an accredited college or university preferred
- Professional certification as applicable to line of business preferred
- Ability to investigate claims and gather information to determine exposure
- Ability to manage claims through investigation, benefit determination, settlement negotiation, and resolution
- Ability to calculate and assign reserves
- Ability to calculate and pay benefits and make claim payments and adjustments
- Ability to prepare necessary state filings within statutory limits
- Ability to manage litigation processes
- Ability to report claims to excess carriers and respond to requests for direction
- Clear and conceptual thinking ability
- Excellent judgment, troubleshooting, problem solving, analysis, and discretion
- Ability to handle work-related stress and multiple priorities simultaneously
- Ability to meet deadlines
- Computer keyboarding
- Hearing, vision, and talking
Benefits
Comp & perks- Flexible work schedule
- Referral incentive program
- Career development and promotional growth opportunities
- Medical, dental, and vision insurance
- 401K and matching
- PTO
- Disability and life insurance
- Employee assistance
- Flexible spending or health savings account
- Other additional voluntary benefits
- Flexibility and autonomy in daily work, location, and career path
- Professional development opportunities