Senior CA Workers' Comp Adjuster - Complex Claims Expert

Jonus Group; Worcester (MA); On-site; USD 90,000 - 120,000; Full time

Job summary

Jonus Group is seeking a Senior California Workers' Compensation Adjuster to join its claims team. This role handles complex workers' compensation claims, including litigated files, while guiding internal stakeholders and junior staff.

The candidate will independently manage a caseload, conduct investigations, set reserves, and collaborate with defense counsel and medical professionals to develop strategies and ensure regulatory compliance.

Qualifications

• Bachelor's degree preferred; equivalent experience will be considered.
• 5+ years of workers' compensation claims handling experience within an insurance carrier environment.
• Strong knowledge of California workers' compensation laws, regulations, and procedures.
• Experience managing litigated and complex claims.
• Ability to obtain and maintain required adjuster licensing and continuing education requirements.

Responsibilities

• Independently manage a caseload of moderate to complex workers' compensation claims.
• Conduct thorough investigations, evaluate compensability and coverage, and issue appropriate claim documentation.
• Set and maintain accurate reserves and authorize payments within designated authority.
• Collaborate with defense counsel, medical professionals, vendors, and other stakeholders to develop effective claim strategies.
• Manage litigated claims and negotiate favorable claim resolutions.
• Ensure compliance with all jurisdictional requirements and internal claim handling standards.
• Maintain detailed claim documentation and prepare comprehensive reports.
• Analyze claim trends and leverage technology and data to support effective claim outcomes.
• Provide mentorship and guidance to less experienced claims professionals.
• Participate in training initiatives and contribute to continuous process improvement efforts.

Skills

Negotiation

Litigation management

Analytical skills

Communication

Mentorship

Time management

Education

Bachelor's degree

Job description

Jonus Group is seeking a Senior California Workers' Compensation Adjuster to join its claims team. This role handles complex workers' compensation claims, including litigated files, while guiding internal stakeholders and junior staff.

The candidate will independently manage a caseload, conduct investigations, set reserves, and collaborate with defense counsel and medical professionals to develop strategies and ensure regulatory compliance.