Senior Workers' Comp Claims Specialist (CA)

AF Group; Los Angeles (CA); On-site; USD 65,000 - 109,000; Full time

Job summary

AF Group in Los Angeles, CA, seeks an advanced level workers' compensation claim handler with California experience to investigate claims, determine compensability, and set reserves within authority. This role requires strong judgment, mentorship, and coordination of complex cases.

You will negotiate settlements with attorneys, mentor junior staff, and stay current with California statutes to ensure compliant, timely resolutions within policy guidelines.

Qualifications

• Bachelor's degree in a related field.
• Five years of workers' compensation claims experience.
• Certification or progress toward certification is highly preferred.
• Experience handling claims across multiple jurisdictions preferred.
• Bilingual skills preferred.

Responsibilities

• Verifies workers' compensation coverage of employers and injured employees.
• Determines claim compensability after thorough investigation.
• Determines causal relationship between injury and incident for proper payment of benefits.
• Facilitates return to work for the injured employee.
• Establishes timely reserves within authority based on claim profile.
• Documents specifics of claims with potential for subrogation recovery.
• Manages medical bills for related claims.
• Negotiates settlements within authority at earliest feasible point.
• Mentors team members and coordinates special projects.
• Stays abreast of changes in workers' compensation laws and rehab efforts.

Skills

Negotiation

Customer service

Analytical skills

Decision making

Independent work

Communication

Education

Bachelor's degree in a related field

Certification in workers' compensation (preferred)

5 years workers' comp claims experience

Job description

AF Group in Los Angeles, CA, seeks an advanced level workers' compensation claim handler with California experience to investigate claims, determine compensability, and set reserves within authority. This role requires strong judgment, mentorship, and coordination of complex cases.

You will negotiate settlements with attorneys, mentor junior staff, and stay current with California statutes to ensure compliant, timely resolutions within policy guidelines.