Senior WC Claims Adjuster — Complex & High-Exposure (Remote)

AvonRisk; Rocklin (CA); Hybrid; USD 62,000 - 103,000; Full time

Benefits offered by this job

Full benefits package

Job summary

AvonRisk is the nation’s leading specialty risk manager for self-insured organizations, providing expert support across workers’ compensation, liability, managed care, and risk management. The role of Workers’ Compensation Claims Adjuster III is a senior technical expert with responsibility for catastrophic injuries, multi-party litigation, and high-exposure cases.

Location and work arrangement can be remote or hybrid depending on candidate location, with opportunities to mentor colleagues, lead

Qualifications

• Minimum 7 years of WC claims experience with independent indemnity management.
• CA SIP certificate required for CA files (CA only).
• Professional designations like AIC/ARM/WCCP/CPCU are a plus but not required.

Responsibilities

• Perform three-point contact on all new losses and apply scrutiny to complex cases.
• Identify fraud indicators and refer to SIU; document facts in multi-party matters.
• Lead medical management on catastrophic/high-cost claims and coordinate life care planning.
• Direct PD rating on complex cases, reserve with justification and timeliness.
• Independently direct litigation process for the unit’s most complex files.
• Lead high-value settlements and coordinate with lien resolution and recovery.
• Mentor Adjuster I/II and support unit-wide quality review.
• Maintain proactive, transparent communication with stakeholders.

Skills

Indemnity management

Complex claims leadership

Client relationship mgmt

Mentoring junior adjusters

Litigation coordination

Education

Bachelor’s degree

Job description

AvonRisk is the nation’s leading specialty risk manager for self-insured organizations, providing expert support across workers’ compensation, liability, managed care, and risk management. The role of Workers’ Compensation Claims Adjuster III is a senior technical expert with responsibility for catastrophic injuries, multi-party litigation, and high-exposure cases.

Location and work arrangement can be remote or hybrid depending on candidate location, with opportunities to mentor colleagues, lead