Senior Workers' Comp Claims Expert – Hybrid

Intercare Holdings Insurance Services; United States; Hybrid; USD 51,000 - 59,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

HSA/FSA contributions

Life and disability insurance

401(k) with company match

PTO and holidays

Employee assistance programs

Job summary

AvonRisk is seeking a Workers’ Compensation Claims Adjuster II to independently manage indemnity claims from intake to resolution across a diversified client base. The role emphasizes sound judgment, medical management, and proactive dispute resolution.

Hybrid position requiring three days per week in-office and collaboration with a team of professionals. CA claims experience and adjuster licensure are required or supported by AvonRisk. Competitive benefits are offered.

Qualifications

• Minimum 3 years of CA WC claims adjusting with a Bachelor's degree.
• 5 years of CA WC claims adjusting without a Bachelor's degree.
• SIP designation preferred but not required; licensure support provided.

Responsibilities

• Perform three-point contact within 24 hours on new losses and analyze case facts.
• Direct medical management including treatment authorization and UR/IME direction.
• Establish and adjust case reserves; prepare 90-day status reports.
• Direct defense counsel, set litigation strategy, manage budgets, attend mediations.
• Negotiate settlements and pursue subrogation and lien recoveries.
• Maintain proactive communication with injured workers, employers, carriers, and vendors.

Skills

WC claims adjusting

Indemnity claims

Litigation management

Subrogation pursuit

Medical management

Fraud indicators

Stakeholder communication

Documentation & reporting

Education

California WC claims adjusting with Bachelor's degree

California WC claims adjusting without Bachelor's degree

Tools

Claims management platforms

Microsoft Office

Read/interpret medical records & IME reports

Job description

AvonRisk is seeking a Workers’ Compensation Claims Adjuster II to independently manage indemnity claims from intake to resolution across a diversified client base. The role emphasizes sound judgment, medical management, and proactive dispute resolution.

Hybrid position requiring three days per week in-office and collaboration with a team of professionals. CA claims experience and adjuster licensure are required or supported by AvonRisk. Competitive benefits are offered.