Senior Complex Workers' Comp Claims Examiner

Synectics Inc.; United States; On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Healthcare Insurance

Dental Insurance

Vision Insurance

401(k) Plan

Job summary

Synectics Inc. is seeking a skilled Workers’ Compensation Claims Examiner to analyze and manage complex CA claims, including litigation, subrogation, and cost containment.

You will negotiate settlements and calculate reserves while ensuring compliance with state laws and client requirements. The role requires a Bachelor's degree, SIP Certification, 5+ years of California WC experience, and strong negotiation, communication, and analytics skills.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• SIP Certification and California WC expertise highly regarded.
• 5+ years of claims management experience in California workers' compensation.
• Strong negotiation, analytical and communication skills.

Responsibilities

• Analyze complex workers' compensation claims and determine benefits and settlements.
• Investigate, gather information, and manage claims to timely resolution.
• Negotiate settlements within designated authority and manage reserves.
• Calculate and pay benefits, and document claim files accurately.
• Prepare state filings within statutory limits and coordinate litigation when needed.
• Coordinate vendor referrals for investigation or litigation management.
• Support cost containment and subrogation efforts for clients.
• Report claims to excess carriers and maintain client communications.
• Travel as required.

Education

Bachelor's degree

SIP Certification

Tools

Microsoft Office

Job description

Synectics Inc. is seeking a skilled Workers’ Compensation Claims Examiner to analyze and manage complex CA claims, including litigation, subrogation, and cost containment.

You will negotiate settlements and calculate reserves while ensuring compliance with state laws and client requirements. The role requires a Bachelor's degree, SIP Certification, 5+ years of California WC experience, and strong negotiation, communication, and analytics skills.