Remote Senior WC Claims Strategist — California/Oregon

Great American Insurance Group; Northern (KY); Hybrid; USD 105,000 - 125,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Wellness program

Parental leave

Adoption assistance

Tuition reimbursement

PTO

Holidays

401(k) match

Employee stock purchase plan

Commuter benefits

Job summary

Great American Insurance Group is seeking a Senior Claims Specialist to manage California and Oregon workers' compensation claims from inception through resolution. This remote role requires working Pacific Time Zone business hours and a strong track record in complex claims.

The ideal candidate has 10+ years of WC claims experience, California expertise, and professional designations such as AIC. Excellent communication skills are essential for collaborating with claimants, insureds, and

Qualifications

• 10+ years of workers' compensation claims adjusting experience, including complex or high-exposure claims.
• California experience required; Oregon experience also preferred but not required.
• Professional industry designations such as AIC are preferred.
• Ability to work Pacific Time Zone business hours and travel occasionally as needed.
• You must be a great communicator, in both written and verbal form, and be able to work with a variety of internal and external contacts.

Responsibilities

• Manage California and Oregon 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 Illinois workers' compensation laws and regulations.
• Maintain accurate and timely claim documentation.
• Analyze claim trends and exposure to support effective decision-making.
• Provide exceptional service while building strong relationships with customers and business partners.

Education

AIC designation (Associate in Claims)

Job description

Great American Insurance Group is seeking a Senior Claims Specialist to manage California and Oregon workers' compensation claims from inception through resolution. This remote role requires working Pacific Time Zone business hours and a strong track record in complex claims.

The ideal candidate has 10+ years of WC claims experience, California expertise, and professional designations such as AIC. Excellent communication skills are essential for collaborating with claimants, insureds, and