Senior CA Workers’ Comp Claims Examiner

Acrisure; Medford (OR); On-site; USD 95,000 - 110,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) plan

Job summary

Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This role requires hands-on experience with CA claims and active certification.

The ideal candidate will assess exposure, develop resolution strategies, and coordinate with defense, medical providers, and employers while upholding CA regulations.

Qualifications

• 5+ years of experience handling California workers' compensation claims.
• Experience managing indemnity and litigated claims.
• Active California Adjuster Certification, OSIP/SIP self‑insured qualification, or CWCP designation.
• Strong knowledge of California workers' compensation laws and claims handling practices.
• Ability to independently manage complex claims with minimal supervision.

Responsibilities

• Independently manage a caseload of California workers' compensation claims from assignment through resolution.
• Investigate claims, evaluate compensability, and determine appropriate claim handling strategies.
• Review coverage, liability, medical documentation, and claim exposure in accordance with California regulations.
• Establish and manage reserves based on claim exposure and ongoing developments.
• Manage complex indemnity claims, including litigated files and settlement negotiations.
• Coordinate with defense counsel, medical providers, employers, and other stakeholders throughout the claims process.
• Monitor claim progress, maintain diaries, and ensure timely follow‑up on all assigned files.
• Coordinate return‑to‑work efforts and support positive claim outcomes.
• Identify fraud, subrogation, and cost containment opportunities when appropriate.
• Maintain complete, accurate, and timely documentation within the claims management system.
• Provide guidance and claim recommendations on complex files as needed.
• Perform additional duties and projects as assigned.

Skills

CA WC knowledge

Litigation experience

Analytical skills

Communication skills

Organizational skills

MS Office / claims systems

Education

High school diploma

CWCP designation

CA Adjuster Certification

OSIP/SIP self-insured qualification

Tools

Microsoft Office

Claims management systems

Job description

Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This role requires hands-on experience with CA claims and active certification.

The ideal candidate will assess exposure, develop resolution strategies, and coordinate with defense, medical providers, and employers while upholding CA regulations.