Senior Workers' Comp Claims Adjuster – Complex & Subrogation

AvonRisk; Orange (CA); On-site; USD 80,000 - 100,000; Full time

Benefits offered by this job

Comprehensive benefits

401(k) with company match

Paid time off

Job summary

AvonRisk is seeking a Claims Specialist to manage an inventory of complex claim files. You will document facts, establish compensability, and collaborate with medical case managers to optimize outcomes while adhering to statutes and company guidelines.

The role requires strong problem-solving, customer service, and teamwork skills, with a background in California workers' compensation claims and SIP certification. Competitive salary and benefits offered.

Qualifications

• Bachelor's degree from four-year college or university is required.
• Minimum of seven years related experience and/or training; or equivalent.
• Requires SIP certificate and proven claims handling expertise.

Responsibilities

• Perform three-point contact on all new losses within 24 hours to document facts.
• Document ongoing case facts for compensability, disability payments, and vendor use.
• Maintain up-to-date plan of action for indemnity claims and move cases toward closure.
• Partner with medical case manager to maximize early return-to-work potential and reduce costs.
• Initiate referral to SIU for suspected fraud and pursue subrogation.
• Ensure claims handling complies with statutes, contracts, and guidelines.

Skills

Problem Solving

Customer Service

Interpersonal

Team Work

Education

Bachelor's degree

7+ years experience

SIP certificate

Job description

AvonRisk is seeking a Claims Specialist to manage an inventory of complex claim files. You will document facts, establish compensability, and collaborate with medical case managers to optimize outcomes while adhering to statutes and company guidelines.

The role requires strong problem-solving, customer service, and teamwork skills, with a background in California workers' compensation claims and SIP certification. Competitive salary and benefits offered.