Senior CA Workers' Comp Claims Examiner (Remote)

TechLife Columbus; California, Northern (MO, KY); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Revel IT in California is seeking an experienced Workers’ Compensation Claims Examiner to analyze complex California WC claims and determine benefits. This remote role supports clients from CA with potential travel when required.

You will negotiate settlements, manage reserves, coordinate litigation and subrogation, and ensure timely processing while complying with law and client guidelines. A minimum of five years’ claims management experience and CA WC background are preferred.

Qualifications

• Bachelor’s degree preferred; professional certification as applicable to line of business preferred.
• Five (5) years of claims management experience or equivalent combination of education and experience required.

Responsibilities

• Analyze and process complex or technically difficult workers’ compensation claims by investigating and gathering information to determine exposure; manage claims through action plans.
• Negotiate settlement of claims within designated authority.
• Calculates and assigns reserves and manages reserve adequacy.
• Calculates and pays benefits due and settles claims within authority.
• Prepare necessary state filings within statutory limits.
• Manage the litigation process; coordinate vendor referrals.
• Use cost containment techniques including vendor partnerships to reduce costs.
• Manage claim recoveries including subrogation and Social Security/Medicare offsets.
• Report claims to excess carrier and communicate with claimant and client.

Skills

Insurance knowledge

Negotiation skills

Analytical skills

Communication skills

Teamwork

Cost containment

Attention to detail

MS Office

Education

Bachelor's degree

Professional certification (optional)

Tools

Microsoft Office

Job description

Revel IT in California is seeking an experienced Workers’ Compensation Claims Examiner to analyze complex California WC claims and determine benefits. This remote role supports clients from CA with potential travel when required.

You will negotiate settlements, manage reserves, coordinate litigation and subrogation, and ensure timely processing while complying with law and client guidelines. A minimum of five years’ claims management experience and CA WC background are preferred.