Senior California Workers' Comp Claims Examiner (Remote)

Acrisure; Murrieta (CA); On-site; USD 95,000 - 110,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life and disability insurance

401(k) plan

HSA/FSA options

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 California Adjuster Certification or CWCP, and hands‑on experience with SIP/OSIP self‑insured claims.

The position is fully remote with hours aligned to Mountain or Pacific Time zones, and emphasizes reviewing claims, negotiating settlements, and managing reserves while ensuring regulatory compliance.

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 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.
• 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

Analytical skills

Decision making

Problem solving

Communication skills

Organizational skills

Remote work discipline

Education

High school diploma or equivalent

CA Adjuster Certification / SIPOSIP qualification / 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 California Adjuster Certification or CWCP, and hands‑on experience with SIP/OSIP self‑insured claims.

The position is fully remote with hours aligned to Mountain or Pacific Time zones, and emphasizes reviewing claims, negotiating settlements, and managing reserves while ensuring regulatory compliance.