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About the role
Key responsibilities & impact- Analyze complex or technically difficult California workers' compensation claims to determine benefits due
- 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 and ensure timely, cost-effective claims resolution
- Report claims to the excess carrier and respond to requests for directions
- Identify claim subrogation and negotiate settlements
- Deliver customer-facing solutions and collaborate with clients and global experts
Requirements
What you’ll need- California workers' compensation experience
- Four (4) years of California workers' compensation claims management experience, or equivalent combination of education and experience
- Experience handling litigated and high-exposure claims
- Understanding of California jurisdictional requirements
- Experience managing claims through investigation, benefit determination, settlement negotiation, and resolution
- Bachelor's degree from an accredited college or university preferred
- Professional certification as applicable to line of business preferred
- California jurisdictional knowledge required
- SIP required or must be obtained within one year of hire date
- Ability to analyze complex or technically difficult workers' compensation claims
- Ability to investigate and gather claim exposure information
- Ability to calculate and assign reserves and benefits
- Ability to manage litigation processes
- Ability to prepare necessary state filings within statutory limits
- 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 abilities
Benefits
Comp & perks- Flexible work schedule
- Referral incentive program
- Career development and promotional growth opportunities
- Medical, dental, and vision coverage
- 401(k) and matching
- Paid time off (PTO)
- Disability and life insurance
- Employee assistance program
- Flexible spending account or health savings account
- Other additional voluntary benefits
- Flexible location and autonomy in daily work