Remote Senior CA Workers' Comp Claims Specialist

Great American Insurance Group; Sacramento (CA); A distancia; USD 105.000 - 125.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, and vision coverage

Paid Time Off and paid holidays

401(k) plan with company match

Commuter benefits

Descripción de la vacante

Great American Insurance Group is seeking a Senior Claims Specialist to manage California workers' compensation claims. This remote role operates in Pacific Time and emphasizes aggressive, proactive claims strategy, compensation evaluation, and settlements.

You will investigate claims, establish reserves, negotiate outcomes, and coordinate with medical case managers and defense counsel to achieve favorable resolutions while ensuring regulatory compliance.

Formación

• 10+ years of workers' compensation claims adjusting experience, including complex or high-exposure claims.
• CA workers' compensation laws and practices exposure.
• Professional designation such as Associate in Claims (AIC) preferred.

Responsabilidades

• Manage California workers' compensation claims from inception through resolution.
• Analyze claim facts and evaluate coverage, compensability, and benefits eligibility.
• Develop and execute strategies to achieve timely and favorable claim outcomes.
• Establish and maintain appropriate claim reserves.
• Negotiate settlements and bring about claim resolution.
• Communicate regularly with claimants, insureds, employers, and other stakeholders.
• Prepare and present large loss reports to internal and external audiences.
• Collaborate with defense counsel on litigation strategy and claim resolution.
• Partner with medical case managers, surveillance vendors, and other external resources.
• Ensure compliance with California workers' compensation laws and regulations.
• Maintain accurate and timely claim documentation.
• Analyze claim trends and exposure to support effective decision-making.

Conocimientos

10+ years of workers' compensation

California experience

Educación

AIC designation preferred

Descripción del empleo

Great American Insurance Group is seeking a Senior Claims Specialist to manage California workers' compensation claims. This remote role operates in Pacific Time and emphasizes aggressive, proactive claims strategy, compensation evaluation, and settlements.

You will investigate claims, establish reserves, negotiate outcomes, and coordinate with medical case managers and defense counsel to achieve favorable resolutions while ensuring regulatory compliance.