Senior Workers' Comp Claims Strategist - Hybrid

Southern California Edison (SCE); Rosemead (CA); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Southern California Edison (SCE) is seeking a Senior Workers' Compensation Claims Adjuster to expertly manage a complex caseload, including catastrophic claims, within a self-insured environment. You will coordinate investigations with management, medical providers, workers, and witnesses to determine liability and ensure timely, fair outcomes.

The role emphasizes cost containment, proper reserves, and compliance with California WC laws, AOE/COE, and WCAB proceedings, while safeguarding

Qualifications

• Seven or more years of experience in processing workers' compensation claims.
• Experience evaluating accident reports for regulatory compliance.

Responsibilities

• Manage a complex workers' compensation claim caseload, including catastrophic claims.
• Conduct investigations with management, medical providers, injured workers, and witnesses.
• Administer benefits and control medical costs, ensuring access to quality care.
• Identify fraud and pursue third-party and excess recoveries.
• Manage complex litigation and represent SCE at WCAB proceedings.

Skills

Communication skills

Claims management software

Knowledge of WC laws

Investigation skills

Education

Bachelor’s degree in business or related field

California Workers’ Compensation Claim Adjuster Certification

Self-Insured Certificate

Job description

Southern California Edison (SCE) is seeking a Senior Workers' Compensation Claims Adjuster to expertly manage a complex caseload, including catastrophic claims, within a self-insured environment. You will coordinate investigations with management, medical providers, workers, and witnesses to determine liability and ensure timely, fair outcomes.

The role emphasizes cost containment, proper reserves, and compliance with California WC laws, AOE/COE, and WCAB proceedings, while safeguarding