Senior Remote Workers' Comp Claims Adjuster

EMC Insurance Companies; California; Remote; USD 79,000 - 120,000; Full time

Job summary

EMC Insurance Companies is seeking an experienced workers' compensation claims professional in California. You will own moderately to highly complex claims, drive investigations, evaluate coverage, set reserves, and shape claim strategies from start to resolution.

You will build strong client relationships, ensure regulatory compliance, mentor teammates, and contribute to team performance while advancing settlements and subrogation opportunities.

Qualifications

• Bachelor’s degree or equivalent, plus claims adjusting experience.
• Experience with third party administrators (TPA) preferred.
• Coursework or designation such as CPCU or related licenses preferred.

Responsibilities

• Analyze coverage and confirm losses are covered under client policies.
• Initiate contact within 24 hours with relevant parties (clients, claimants, providers).
• Conduct thorough investigations, including fact-finding and recorded statements.
• Develop action plans to resolve claims efficiently and set reserves per guidelines.
• Negotiate settlements, participate in mediation, and manage payments within authority.

Skills

Claims handling expertise

Investigations

Reserves analysis

Negotiation

Regulatory compliance

Education

Bachelor’s degree or equivalent

CPCU coursework or designation

INS/AIC/SCLA/WCLA coursework

Job description

EMC Insurance Companies is seeking an experienced workers' compensation claims professional in California. You will own moderately to highly complex claims, drive investigations, evaluate coverage, set reserves, and shape claim strategies from start to resolution.

You will build strong client relationships, ensure regulatory compliance, mentor teammates, and contribute to team performance while advancing settlements and subrogation opportunities.