Remote Senior California Workers' Comp Claims Examiner

Acrisure; San Francisco (CA); Remote; USD 90,000 - 110,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

401(k) plan

HSA/FSA options

Paid time off

Job summary

Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This role requires hands-on experience with California laws and an active CA Adjuster Certification, OSIP/SIP qualification, or CWCP designation.

Remote position with California-based support during Mountain or Pacific Time. The role emphasizes investigation, reserving, litigation management, settlements, and collaboration

Qualifications

• 5+ years of experience handling California workers' compensation claims.
• Experience managing indemnity claims required.
• Experience handling litigated workers' compensation claims required.
• Current California Adjuster Certification, OSIP/SIP self-insured qualification, or CWCP designation required.

Responsibilities

• Independently manage a caseload of California workers' compensation claims to resolution.
• Investigate claims, evaluate compensability, and determine handling strategies.
• Review coverage, liability, medical documentation, and claim exposure per CA regulations.
• Establish and manage reserves based on exposure and developments.
• Manage complex indemnity claims, including litigated files and settlements.
• Coordinate with defense counsel, medical providers, employers, and stakeholders.
• Monitor progress, diaries, and timely follow-ups on all files.
• Coordinate return-to-work efforts and support positive outcomes.
• Identify fraud, subrogation, and cost containment opportunities.
• Maintain complete, accurate documentation in the system.
• Provide guidance on complex files as needed.
• Perform additional duties as assigned.

Skills

California workers' comp

Indemnity claims

Litigated claims

Claim strategy

Negotiation

Communication

Time management

Education

High school diploma or equivalent

Tools

Microsoft Office

Claims management systems

Job description

Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This role requires hands-on experience with California laws and an active CA Adjuster Certification, OSIP/SIP qualification, or CWCP designation.

Remote position with California-based support during Mountain or Pacific Time. The role emphasizes investigation, reserving, litigation management, settlements, and collaboration