Senior Workers' Comp Claims Adjuster - Remote

PMA Companies; Roseville (CA); Remote; USD 80.000 - 105.000; Vollzeit

Zusammenfassung

PMA Companies is seeking a claims professional in California to independently investigate and resolve complex workers' compensation claims. You will determine coverage, negotiate settlements, manage reserves, and collaborate with PMA nurses on return-to-work strategies.

The role requires strong organization, communication, and knowledge of jurisdictional guidelines. Travel is minimal (less than 10%), and the position offers a salary range of $80,000–$105,000 with fulltime eligibility.

Qualifikationen

• Bachelor's degree or equivalent work experience in the insurance industry is required.
• 3–5 years' experience handling lost time workers' compensation claims, with California jurisdiction experience.
• Active license required or must be obtainable within 90 days in mandated states.
• Familiarity with medical terminology and Workers' Compensation concepts.
• Strong organizational, independent work, and multi-tasking abilities.
• Excellent verbal and written communication and customer service skills.
• Travel up to 10% for business.

Aufgaben

• Independently investigate and resolve complex workers' compensation claims.
• Determine coverage, compensability, and subrogation potential; alert supervisors as needed.
• Establish and adjust reserves with documented rationale.
• Negotiate settlements with client approval and manage case resolution plans.
• Collaborate with PMA nurses on return-to-work strategies and vendor selection.
• Maintain knowledge of state requirements and applicable case law.

Kenntnisse

Investigative skills

Claims handling

Communication

Analytical thinking

Attention to detail

Ausbildung

Bachelor's degree

AIC designation desired

Tools

MS Office

Jobbeschreibung

PMA Companies is seeking a claims professional in California to independently investigate and resolve complex workers' compensation claims. You will determine coverage, negotiate settlements, manage reserves, and collaborate with PMA nurses on return-to-work strategies.

The role requires strong organization, communication, and knowledge of jurisdictional guidelines. Travel is minimal (less than 10%), and the position offers a salary range of $80,000–$105,000 with fulltime eligibility.