Senior WC Claims Adjuster - Complex & High-Exposure

InterMed Cost Containment Services; Rocklin (CA); Hybrid; USD 100,000 - 102,000; Full time

Job summary

AvonRisk is seeking a senior Workers’ Compensation Claims Adjuster III to handle the organization’s most complex, high-exposure claims. You will provide technical guidance to peers and act as a senior resource for clients, carriers, and colleagues in a dynamic, remote/hybrid environment.

The role requires CA SIP certification for CA files, a valid adjuster license, and extensive experience in complex WC indemnity management across multiple jurisdictions.

Qualifications

• Minimum 7 years of WC claims experience including at least 5 years of independent indemnity management.
• CA SIP certificate required for CA files.
• Active adjuster license in applicable state(s).

Responsibilities

• Perform complex, high-exposure claims investigations with strategic resolution plans.
• Lead medical management for catastrophic/high-complexity claims.
• Lead PD rating on complex cases and manage reserves.
• Direct litigation, select defense counsel, manage spend.
• Negotiate settlements and manage lien resolution.

Skills

Complex claims

Fraud detection

Medical management

Leadership

Client relationships

Education

Bachelor’s degree

Tools

Claims platforms

Microsoft Office

Job description

AvonRisk is seeking a senior Workers’ Compensation Claims Adjuster III to handle the organization’s most complex, high-exposure claims. You will provide technical guidance to peers and act as a senior resource for clients, carriers, and colleagues in a dynamic, remote/hybrid environment.

The role requires CA SIP certification for CA files, a valid adjuster license, and extensive experience in complex WC indemnity management across multiple jurisdictions.