Remote Workers’ Comp Adjuster in CA — Claims Expert

Questpro; California (MO); On-site; USD 65,000 - 95,000; Full time

Job summary

Questpro, in partnership with a well-established leader in claims management, seeks a Workers' Compensation Adjuster handling California claims (License Required). This remote role is ideal for someone with experience at a TPA and a passion for risk management.

You will evaluate claims, manage end-to-end processes, negotiate resolutions, and document files with precision while collaborating with clients, counsel, and medical professionals.

Qualifications

• Bachelor's degree or equivalent experience in insurance or claims management.
• 3+ years of workers' compensation claims adjusting experience.
• Strong analytical skills and sound, data-informed judgment.
• Excellent communication and interpersonal skills - assertive, empathetic, and diplomatic.
• Proficiency with claims management software and Microsoft Office.

Responsibilities

• Evaluate claims: Conduct thorough investigations and deliver well-supported claim determinations.
• Administer processes: Manage claims end-to-end in compliance with jurisdictional guidelines and internal protocols.
• Negotiate resolutions: Drive negotiations with claimants, attorneys, and physicians to settle claims cost-effectively.
• Document with precision: Maintain complete, current, and accurate claim files.
• Advocate for stakeholders: Partner with clients, counsel, and medical professionals to reach the best resolution.
• Analyze trends: Identify and report emerging claim trends to improve process and service quality.

Skills

Analytical skills

Communication skills

Education

Bachelor's degree or equivalent in insurance/claims

Tools

Claims management software

Microsoft Office

Job description

Questpro, in partnership with a well-established leader in claims management, seeks a Workers' Compensation Adjuster handling California claims (License Required). This remote role is ideal for someone with experience at a TPA and a passion for risk management.

You will evaluate claims, manage end-to-end processes, negotiate resolutions, and document files with precision while collaborating with clients, counsel, and medical professionals.