Claims Adjuster – Workers Compensation

Jobtailor; Ontario (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

Jobtailor is seeking an experienced claims professional in California to analyze and process workers' compensation claims, investigate information, and determine exposure. You will negotiate settlements within your authority and communicate progress to claimants and clients, ensuring timely resolutions.

The role requires handling claims with precision, reporting to the excess carrier, and complying with service expectations and client requirements. Travel may be required as part of the job.

Qualifications

• 4 years of claims management experience or equivalent combination of education and experience.
• High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• California workers' compensation claims handling experience.
• SIP certification preferred.
• Ability to analyze and process claims.
• Ability to investigate and gather claim information.
• Ability to negotiate settlements within designated authority.
• Clear and conceptual thinking ability.

Responsibilities

• Analyze and process workers' compensation claims through action plans toward timely and appropriate resolution.
• Investigate claims and gather information to determine claim exposure.
• Negotiate claim settlements within designated authority.
• Communicate claim activity and processing with claimants and clients.
• Report claims to the excess carrier.
• Respond professionally and promptly to requests for directions.
• Adjudicate customer claims and determine benefits due while meeting service expectations, industry best practices, and client requirements.

Skills

Claims Analysis

Claims Processing

Investigation Skills

Settlement Negotiation

Adjudication

Computer Keyboarding

Education

High School Diploma

GED

Bachelor's Degree

Job description

• Analyze and process workers' compensation claims through action plans toward timely and appropriate resolution
• Investigate claims and gather information to determine claim exposure
• Negotiate claim settlements within designated authority
• Communicate claim activity and processing with claimants and clients
• Report claims to the excess carrier
• Respond professionally and promptly to requests for directions
• Adjudicate customer claims and determine benefits due while meeting service expectations, industry best practices, and client requirements

Requirements

• 4 years of claims management experience or equivalent combination of education and experience
• High School Diploma or GED required
• Bachelor's degree from an accredited college or university preferred
• Professional certification as applicable to line of business preferred
• California workers' compensation claims handling experience
• SIP certification preferred
• Ability to analyze and process claims
• Ability to investigate and gather claim information
• Ability to negotiate settlements within designated authority
• Clear and conceptual thinking ability
• Excellent judgment, troubleshooting, problem-solving, analysis, and discretion
• Ability to handle work-related stress
• Ability to handle multiple priorities simultaneously
• Ability to meet deadlines
• Computer keyboarding ability
• Travel as required

Core Competencies

Demonstrates expertise in analyzing and processing workers' compensation claims, negotiating settlements, and adhering to industry best practices. Proficient in managing multiple priorities while maintaining excellent judgment and problem-solving abilities.

Highest-signal resume keywords

• Claims Management Experience
• California Workers' Compensation Claims Handling
• Negotiation Skills
• SIP Certification
• Analytical Skills

ATS Optimization Keywords

Hard Skills

• Claims Analysis
• Claims Processing
• Investigation Skills
• Settlement Negotiation
• Adjudication
• Computer Keyboarding

Soft Skills

• Clear Thinking
• Excellent Judgment
• Problem-Solving
• Discretion
• Stress Management

Certifications & Qualifications

• High School Diploma
• GED
• Bachelor's Degree
• Professional Certification
• SIP Certification

Industry Keywords

• Workers' Compensation
• Claims Handling
• Client Requirements
• Service Expectations
• Excess Carrier Reporting