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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, appropriate reserves and manage reserve adequacy throughout the claim lifecycle
- Calculate and pay benefits; approve and make timely claim payments and adjustments
- Settle claims within designated authority level
- Prepare necessary state filings within statutory limits
- Manage the litigation process and ensure timely, cost-effective claims resolution
- Report claims to the excess carrier and respond to requests for direction professionally and promptly
- Identify subrogation opportunities and negotiate settlements
Requirements
What you’ll need- California workers' compensation claims experience
- Three (3) 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
- Experience handling litigated and high-exposure claims
- Knowledge of California jurisdictional requirements
- Ability to manage claims through investigation, benefit determination, settlement negotiation, and resolution
- 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
- Work authorization in the United States implied by eligibility for U.S.-located candidates
Benefits
Comp & perks- Flexible work schedule
- Referral incentive program
- Career development and promotional growth opportunities
- Medical, dental, and vision insurance
- 401(k) and matching
- Paid time off (PTO)
- Disability and life insurance
- Employee assistance program
- Flexible spending or health savings account
- Additional voluntary benefits
- Remote work / work-at-home arrangement