Senior Workers' Comp Claims Examiner — Complex Caseload

TEEMA; Corona (CA); On-site; USD 75,000 - 105,000; Full time

Job summary

TEEMA is seeking an experienced Claims Examiner to independently manage a full-cycle workers’ compensation caseload in California, handling highly complex indemnity claims within established authority. This office-based role requires strong communication with claimants, attorneys, medical providers, and internal stakeholders, plus disciplined scheduling and reliable attendance.

The ideal candidate has 5+ years WC claims experience, active California SIP certification, and a Bachelor’s degree

Qualifications

• Bachelor’s degree in a related field preferred.
• 5+ years’ workers’ compensation claims experience.
• Active California SIP certification required.
• Strong knowledge of workers’ compensation laws.

Responsibilities

• Manage a caseload of 150–180 workers’ compensation claims, including complex indemnity cases.
• Conduct timely investigations to determine claim compensability.
• Administer benefits per state regulations and guidelines.
• Oversee medical treatment plans and approve services/billing.
• Coordinate with defense counsel on litigated claims.
• Communicate with claimants, providers, vendors, and clients regarding claim status and issues.
• Establish and maintain reserves within authority.
• Negotiate and finalize settlements within authority levels.
• Maintain accurate claim documentation and diary systems.
• Provide clients with updates including injury trends and risk insights.
• Conduct independent file reviews for compliance.
• Perform additional duties as assigned.

Skills

WC claims knowledge

Investigation skills

Regulatory knowledge

Communication

Negotiation

Documentation

Education

Bachelor's degree (preferred)

California SIP certification

Job description

TEEMA is seeking an experienced Claims Examiner to independently manage a full-cycle workers’ compensation caseload in California, handling highly complex indemnity claims within established authority. This office-based role requires strong communication with claimants, attorneys, medical providers, and internal stakeholders, plus disciplined scheduling and reliable attendance.

The ideal candidate has 5+ years WC claims experience, active California SIP certification, and a Bachelor’s degree