Senior Workers’ Compensation Indemnity Claims Adjuster | Remote

The ideal candidate will have strong California workers’ compensation knowledge, experience independently managing a claim inventory, and the ability to communicate effectively with injured employees, medical providers, attorneys, and other involved parties. Candidates must reside in Fresno, CA, or the surrounding area.

Responsibilities

• Manage a caseload of California workers’ compensation claims from initial reporting through closure.

• Investigate new claims, evaluate compensability, and determine appropriate benefits in accordance with California workers’ compensation regulations.

• Calculate and issue temporary disability, permanent disability, and other applicable indemnity benefits.

• Review medical documentation, treatment recommendations, work restrictions, and disability status to determine appropriate claim activity.

• Coordinate with injured employees, employers, medical providers, attorneys, and other parties throughout the life of the claim.

• Establish appropriate reserves and regularly evaluate claim exposure based on medical, legal, and financial developments.

   

Qualifications

• Minimum of 3 years of workers’ compensation claims adjusting or examining experience.

• Strong knowledge of California workers’ compensation laws, regulations, and claims-handling requirements.

• Experience handling claims from initial investigation through litigation and final closure.

• Previous experience within a self-insured environment is highly preferred.

• California Self-Insurance Administrator’s Certificate is required, or the ability to obtain the certification within the required timeframe.

• Strong understanding of indemnity benefits, medical management, reserving, litigation, and settlement practices.

Salary & Benefits

• $90,000–$110,000 (based on experience)

• Comprehensive medical, dental, and vision insurance.

• Employer-sponsored retirement benefits.

• Paid vacation, sick leave, and holidays.

• Employer-provided life insurance.