Workers' Compensation Claims Representative - California

Job Summary

Seeking a highly skilled and experienced Workers' Compensation Claims Representative to join a team. This is a fully remote position, allowing you to work from anywhere within the continental United States. The ideal candidate will have a strong background in handling workers' compensation claims and possess the necessary certifications and qualifications to excel in this role. If you are a detail-oriented professional with excellent communication and negotiation skills, we encourage you to apply.

Compensation Package

• Competitive salary range: $85,000 - $100,000 (up to $105,000 based on experience)
• Comprehensive benefits package
• Opportunity to work remotely from anywhere in the continental U.S.

Responsibilities

• Assess compensability and coverage issues for lost time workers' compensation claims.
• Manage a caseload of lost time claims across multiple jurisdictions effectively.
• Negotiate and direct settlements under management's review.
• Collect and analyze medical and factual evidence to determine claim compensability.
• Oversee outside investigations and manage litigation files within assigned authority.
• Maintain consistent communication with claimants, attorneys, outside investigators, rehabilitation personnel, insureds, account liaisons, and medical providers.

Qualifications/Requirements

• A minimum of 3 years of experience in workers' compensation claims handling.
• Proven experience managing claims in California.
• SIP certification is required.
• Bachelor's degree is mandatory.
• Prior experience with an insurance carrier is preferred.
• Proficiency in handling lost time or litigated claims.
• Familiarity with medical terminology.
• Strong organizational, problem-solving, negotiation, and conflict resolution skills.
• Excellent verbal and written communication abilities.

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