Senior California WC Claims Examiner — Remote

Acrisure; Sacramento (CA); Remote; USD 90.000 - 100.000; Vollzeit

Zusammenfassung

Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This fully remote role requires supporting California-based claims and working hours aligned with Mountain or Pacific Time zones.

Candidates must have direct CA WC experience, active CA Adjuster Certification, OSIP/SIP self-insured qualification, or CWCP designation, and strong skills in litigation management, settlements,

Qualifikationen

• 5+ years of experience handling California workers' compensation claims.
• Experience managing indemnity and litigated claims.
• Current California Adjuster Certification, OSIP/SIP or CWCP designation required.
• Strong knowledge of California workers' compensation laws and practices.
• Excellent written and verbal communication skills.
• Ability to independently manage complex claims in a remote environment.
• Proficiency with Microsoft Office and claims management systems.

Aufgaben

• 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 developments.
• Manage complex indemnity claims, including litigated files and settlement negotiations.
• Coordinate with defense counsel, medical providers, employers, and other stakeholders.
• Monitor claim progress, maintain diaries, and ensure timely follow-up.
• 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 in the claims system.
• Provide guidance on complex files as needed.
• Perform additional duties and projects as assigned.

Ausbildung

California Adjuster Certification

OSIP/SIP self-insured qualification

CWCP designation

Tools

Microsoft Office

Claims management system

Jobbeschreibung

Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This fully remote role requires supporting California-based claims and working hours aligned with Mountain or Pacific Time zones.

Candidates must have direct CA WC experience, active CA Adjuster Certification, OSIP/SIP self-insured qualification, or CWCP designation, and strong skills in litigation management, settlements,