Claims Adjuster - Workers Compensation

Claims Adjuster II – California Workers’ CompensationLocations: Los Angeles, CA | Walnut Creek, CA | Portland, OR | Downers Grove, ILSchedule: Hybrid – 2 days onsite / 3 days remoteHours: Monday–Friday, 8:00 AM–5:00 PM CSTPay Rate: $60–$65/hourEmployment Type: 6-Month Contract with Potential for Extension or Conversion

Learn more about the general tasks related to this opportunity below, as well as required skills.
Position OverviewWe are conducting a confidential search for an experienced Workers’ Compensation Claims Adjuster to join the claims organization of a large, established insurance company. This position is specifically focused on California Workers’ Compensation claims and requires hands-on experience managing complex and litigated files. The ideal candidate will have at least 3–5 years of direct California Workers’ Compensation claims experience and a current California claims certification. This is not an entry-level or general claims position. We are seeking an adjuster who can independently manage claims from investigation through resolution, including reserves, medical management, litigation strategy, settlement negotiations and coordination with attorneys and other claims partners.
Key ResponsibilitiesIndependently manage a portfolio of California Workers’ Compensation claims, including complex and litigated mattersReview policy coverage and determine applicability to submitted claimsEstablish and maintain appropriate claim reserves and authorize payments within assigned authorityConduct claim investigations through communication with insureds, claimants, witnesses, medical professionals and other involved partiesEvaluate claims for compensability, exposure and appropriate resolution strategyPartner with attorneys, physicians, nurse case managers, insureds and internal business partners to develop effective claim strategiesManage litigation activity and identify opportunities for timely, cost-effective claim resolutionDevelop and negotiate settlement strategies and packagesMonitor medical treatment and other factors affecting claim exposure and resolutionIdentify potential fraud and coordinate referrals to appropriate investigative resourcesRecognize potential third-party recovery and subrogation opportunitiesMaintain accurate and thorough claim documentationRemain current on California Workers’ Compensation regulations, requirements and industry developments
Required Qualifications3–5+ years of direct California Workers’ Compensation claims handling experience requiredCurrent California claims certification requiredDemonstrated experience managing complex and/or litigated Workers’ Compensation claims requiredHands-on experience establishing and evaluating reservesStrong background in claim investigations, settlements and negotiationsExperience coordinating medical management and working with attorneys, physicians xzbcwsv and nurse case managersStrong knowledge of Workers’ Compensation claims practices and insurance principlesAbility to independently evaluate claim exposure and make sound claims decisionsStrong analytical, organizational and problem-solving skillsExcellent written and verbal communication skillsAbility to effectively manage multiple claims, priorities and deadlines
Preferred QualificationsBachelor’s degree or equivalent professional experienceProfessional insurance or claims designationsExperience handling high-exposure or particularly complex California Workers’ Compensation files
Work ArrangementThis position follows a hybrid schedule of two days onsite and three days remote per week, with Wednesday as a required onsite day.Candidates must be able to work from one of the following markets:Los Angeles, CaliforniaWalnut Creek, CaliforniaPortland, OregonDowners Grove, Illinois