Senior CA Workers' Comp Claims Examiner (Remote)

Acrisure; Sacramento (CA); On-site; USD 95,000 - 145,000; Full time

Benefits offered by this job

Remote work

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, active CA Adjuster Certification or CWCP/SIP OSIP qualifications, and the ability to work in a fully remote environment aligned with Mountain or Pacific Time.

You will investigate claims, determine compensability, review medical documentation, manage reserves, and

Qualifications

• 5+ years of experience handling California workers' compensation claims.
• Experience managing indemnity claims.
• Experience handling litigated workers' compensation claims.
• Current 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 accurate 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.

Skills

California WC claims

Indemnity claims

Litigated claims

Adjuster certification

Regulatory knowledge

Analytical skills

Communication skills

Remote work readiness

Education

High school diploma

California Adjuster Certification / OSIP / SIP / CWCP

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, active CA Adjuster Certification or CWCP/SIP OSIP qualifications, and the ability to work in a fully remote environment aligned with Mountain or Pacific Time.

You will investigate claims, determine compensability, review medical documentation, manage reserves, and