Remote Senior Workers' Comp Claims Adjuster (CA)

emcins; California (MO); Remote; USD 79,000 - 120,000; Full time

Job summary

EMC is seeking an experienced workers' compensation claims professional to own complex claims, drive investigations, set reserves, and shape settlements from start to resolution. This role emphasizes analytical and negotiation skills within a client-focused environment.

This position is eligible to work from home anywhere in California, requiring a Bachelor’s degree and five years of claims adjusting experience (CA WC knowledge preferred). Occasional travel may be needed.

Qualifications

• Bachelor's degree or equivalent experience.
• Five years of claims adjusting experience or related experience.
• Prior experience with a third party administrator (TPA) preferred.
• CA workers' compensation knowledge preferred.

Responsibilities

• Analyze coverage and determine applicable policy.
• Initiate contact within 24 hours with clients, claimants, and providers.
• Conduct thorough investigations and fact-finding.
• Develop action plans to resolve claims efficiently.
• Perform reserve analysis and manage reserves.
• Review medical records for injury and treatment details.
• Identify and pursue subrogation opportunities.
• Negotiate settlements and support litigation when needed.
• Maintain documentation, updates, and client communications.

Skills

Analytical thinking

Investigative skills

Communication skills

Negotiation

Education

Bachelor's degree

CPCU coursework

Tools

Claims systems

Job description

EMC is seeking an experienced workers' compensation claims professional to own complex claims, drive investigations, set reserves, and shape settlements from start to resolution. This role emphasizes analytical and negotiation skills within a client-focused environment.

This position is eligible to work from home anywhere in California, requiring a Bachelor’s degree and five years of claims adjusting experience (CA WC knowledge preferred). Occasional travel may be needed.