Remote Senior CA Workers' Comp Claims Examiner

Acrisure; Red Bluff (CA); On-site; USD 90,000 - 130,000; Full time

Job summary

Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This fully remote role requires active CA Adjuster Certification, SIP/SIP self-insured qualification, or CWCP designation and experience handling self-insured or litigated claims.

Candidates must be proficient in evaluating exposure, negotiating settlements, and coordinating with defense counsel, medical providers, and

Qualifications

• 5+ years of experience handling California workers' compensation claims.
• Experience managing indemnity claims.
• Experience handling litigated workers' compensation claims.
• Current California Adjuster Certification, OSIP/SIP self-insured qualification, or CWCP designation.
• Strong knowledge of California workers' compensation laws, regulations, and claims handling practices.
• Experience developing claim resolution strategies and negotiating settlements.
• Ability to independently manage complex claims with minimal supervision.
• Strong analytical, decision-making, and problem-solving skills.
• Excellent verbal and written communication skills.
• Strong organizational skills with the ability to manage multiple priorities in a remote environment.
• Proficiency with Microsoft Office and claims management systems.

Responsibilities

• Independently manage a caseload of California workers' compensation claims from assignment through resolution
• Investigate claims, evaluate compensability, and determine appropriate claim handling strategies
• Review coverage, liability, medical documentation, and claim exposure in accordance with California regulations
• Establish and manage reserves based on claim exposure and ongoing developments
• Manage complex indemnity claims, including litigated files and settlement negotiations
• Coordinate with defense counsel, medical providers, employers, and other stakeholders throughout the claims process
• Monitor claim progress, maintain accurate diaries, and ensure timely follow-up on all assigned files
• Coordinate return-to-work efforts and support positive claim outcomes
• Identify fraud, subrogation, and cost containment opportunities when appropriate
• Maintain complete, accurate, and timely documentation within the claims management system
• Provide guidance and claim recommendations on complex files as needed
• Perform additional duties and projects as assigned

Skills

CA WC laws

Claims investigation

Litigation handling

Remote work

Communication skills

Education

California Adjuster Certification

CWCP designation

Tools

Microsoft Office

Claims system

Job description

Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This fully remote role requires active CA Adjuster Certification, SIP/SIP self-insured qualification, or CWCP designation and experience handling self-insured or litigated claims.

Candidates must be proficient in evaluating exposure, negotiating settlements, and coordinating with defense counsel, medical providers, and