Remote California WC Claims Specialist

Davies Talent Solutions; United States; Remote; USD 65,000 - 95,000; Full time

Benefits offered by this job

Remote work

Contract-to-perm

Job summary

Davies Talent Solutions is partnering with a health insurance organization to recruit an experienced Workers’ Compensation Claims Adjuster focused on California claims. This 100% remote, long-term contract may lead to permanent placement.

The ideal candidate will manage end-to-end claims, collaborate with clients and vendors, and drive claims toward efficient resolution. Strong investigation and communication skills are essential for success in a fast-paced environment.

Qualifications

• 3–5 years of California Workers’ Compensation claims handling experience.
• Self-Insured Certificate is preferred.
• Experience managing indemnity and litigated claims.
• Bachelor’s degree or equivalent professional experience.
• Strong investigative, analytical and decision-making skills.
• Ability to manage multiple priorities in a fast-paced claims environment.
• Excellent written and verbal communication skills.

Responsibilities

• Conduct and direct claim investigations to determine AOE/COE.
• Establish and maintain accurate reserves based on probable outcomes.
• Authorize appropriate medical treatment and ensure timely indemnity benefits.
• Manage legal aspects of Workers’ Compensation claims, including litigated files.
• Provide exceptional customer service to clients, employers, producers, and injured workers.
• Evaluate settlement opportunities and move claims toward resolution and closure.
• Participate in claim review meetings and communicate with stakeholders.

Skills

California WC claims handling

Investigative/analytical skills

Decision-making under pressure

Written and verbal communication

Education

Bachelor’s degree or equivalent

Tools

Microsoft Office Suite

Job description

Davies Talent Solutions is partnering with a health insurance organization to recruit an experienced Workers’ Compensation Claims Adjuster focused on California claims. This 100% remote, long-term contract may lead to permanent placement.

The ideal candidate will manage end-to-end claims, collaborate with clients and vendors, and drive claims toward efficient resolution. Strong investigation and communication skills are essential for success in a fast-paced environment.