Senior CA Workers' Comp Claims Adjuster – Complex & Litigated

The Jonus Group; Worcester (MA); On-site; USD 90,000 - 130,000; Full time

Job summary

The Jonus Group is seeking a Senior CA Workers' Compensation Adjuster to join its California claims team. The role handles moderate to complex workers' compensation claims, including litigated and high-exposure files, serving as a resource to internal stakeholders and junior staff.

Ideal candidates possess strong negotiation, analytical, and litigation management skills with deep knowledge of California workers' compensation regulations. Licensing and CE requirements must be maintained.

Qualifications

• 5+ years of workers' compensation claims handling experience in an insurance carrier environment.
• 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.
• Investigate, evaluate compensability and coverage, and issue appropriate claim documentation.
• Set and maintain 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 jurisdictional requirements and internal claim handling standards.
• Maintain detailed claim documentation and prepare comprehensive reports.
• Analyze claim trends and leverage 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

Analysis

Communication

Customer service

Mentorship

Litigation

Education

Bachelor's degree

Job description

The Jonus Group is seeking a Senior CA Workers' Compensation Adjuster to join its California claims team. The role handles moderate to complex workers' compensation claims, including litigated and high-exposure files, serving as a resource to internal stakeholders and junior staff.

Ideal candidates possess strong negotiation, analytical, and litigation management skills with deep knowledge of California workers' compensation regulations. Licensing and CE requirements must be maintained.