California Workers' Compensation Claims Examiner | Remote

King's Insurance Staffing; California; Remote; USD 62,000 - 76,000; Full time

Benefits offered by this job

Remote work within California

Competitive hourly rate

Job summary

King's Insurance Staffing is seeking an experienced Senior Workers’ Compensation Claims Examiner to manage a portfolio of complex California workers’ compensation claims from inception through final resolution. The role requires deep technical expertise, independent judgment, and the ability to handle high-exposure matters while delivering strong claim outcomes.

The ideal candidate will navigate California regulations, negotiate settlements, work with legal counsel and medical professionals, and

Qualifications

• Minimum 3+ years handling California Workers’ Compensation claims, including indemnity and litigated files.
• SIP certification is required or preferred.
• Deep knowledge of California Labor Code, DWC procedures and settlement practices.

Responsibilities

• Independently manage a caseload of complex indemnity and litigated California Workers’ Compensation claims.
• Conduct detailed investigations to determine compensability and exposure.
• Establish and maintain accurate financial reserves based on developments and legal considerations.
• Evaluate permanent disability exposure and calculate benefits per California guidelines.
• Negotiate settlements, including Compromise & Release and Stipulated Award agreements.
• Ensure timely administration of indemnity benefits and medical payments.
• Maintain diary management and move files toward resolution.
• Identify subrogation opportunities and coordinate recoveries when applicable.
• Provide clear communication to injured workers, employers, brokers, and stakeholders.
• Participate in peer reviews to ensure technical accuracy and best practices.

Skills

California WC claims

Negotiation

Litigation management

Claims software

Analytical thinking

Tools

Claims management software

Job description

Our client is looking for an experienced Senior Workers’ Compensation Claims Examiner to manage a portfolio of complex California workers’ compensation claims from inception through final resolution. This role requires deep technical expertise, sound judgment, and the ability to independently handle high-exposure and litigated matters while delivering strong claim outcomes and exceptional service.

The ideal candidate is confident navigating California-specific regulations, skilled in negotiation strategy, and comfortable collaborating with legal counsel and medical professionals to drive efficient and compliant claim resolution.

Responsibilities

• Independently manage a caseload of complex indemnity and litigated California Workers’ Compensation claims.
• Conduct detailed investigations to determine compensability, exposure, and appropriate claim strategy.
• Establish and maintain accurate financial reserves based on claim developments, medical exposure, and legal considerations.
• Evaluate permanent disability exposure and calculate benefits in accordance with California rating guidelines.
• Negotiate settlements, including Compromise & Release and Stipulated Award agreements, within granted authority levels.
• Ensure timely administration of indemnity benefits and medical payments in compliance with statutory requirements.
• Maintain proactive diary management and move files efficiently toward resolution.
• Identify subrogation opportunities and coordinate recovery efforts when applicable.
• Provide clear and timely communication to injured workers, employers, brokers, and internal stakeholders. Analyze claim trends, identify risk drivers, and recommend strategies to mitigate overall loss exposure.
• Participate in roundtables and peer file reviews to ensure technical accuracy and best practices.

Requirements

• Minimum 3+ years handling California Workers’ Compensation claims, including complex indemnity and litigated files.
• SIP required
• Demonstrated expertise in California Labor Code, DWC procedures, disability rating, and settlement practices.
• Skilled negotiator with strong litigation management capabilities.
• Proficient in claims management software and documentation systems.
• Strong analytical thinking and sound decision-making skills.

Salary & Benefits

• $45.00 – $55.00 per hour (depending on experience)
• Remote work flexibility within California