Senior Workers Compensation Adjuster

TekWissen ®; Roseville (CA); On-site; USD 80,000 - 99,000; Full time

Job summary

TekWissen Group in Roseville, CA, is seeking a Senior Workers Compensation Adjuster to manage moderate to high-value claims with minimal supervision. The role emphasizes advanced investigative and negotiation skills to resolve disputes and handle escalations.

You will work with internal and external experts, including legal counsel, conduct thorough evaluations, set reserves, and guide junior handlers. This onsite, full-time position requires licensing and travel as needed.

Qualifications

• Bachelor’s degree preferred or equivalent experience.
• 5–10+ years of workers compensation claims handling with an insurer.
• Must possess/state adjuster licenses and CE credits.
• Skilled in negotiating complex claims and influencing outcomes.
• Strong judgment on high-exposure cases including litigation and compliance.
• Excellent verbal and written communication.
• Highly organized with strong time and desk management; mentorship.
• Knowledge of regulatory environment and jurisdictional requirements.
• Empathetic customer service and escalation management.
• Able to work on-site and travel as needed.
• Ability to work in a fast-paced environment.

Responsibilities

• Represent the company in claims litigation forums while upholding professionalism.
• Ensure compliance with regulatory and company standards.
• Lead investigations, assess coverage, and issue reservation of rights and coverage letters.
• Identify opportunities to transfer risk and pursue subrogation.
• Resolve disputes and negotiate favorable outcomes.
• Set reserves and authorize payments within authority.
• Maintain accurate records and prepare reports.
• Coordinate with legal, underwriting, vendors, and agents.
• Mentor junior claim handlers and share best practices.
• Support training and development materials.

Skills

Negotiation skills

Investigative skills

Regulatory knowledge

Mentoring

Communication skills

Cross-functional collaboration

Education

Bachelor’s degree (preferred)

Job description

Job Title: Senior Workers Compensation Adjuster

Job Type: Full time

Work Type: Onsite

Duration: Full time

Pay Rate: $80k-$99k /yearly

Overview

TekWissen is a global workforce management provider headquartered in Ann Arbor, Michigan that offers strategic talent solutions to our clients world-wide.

Job Description

POSITION OVERVIEW:

• The Senior Workers Compensation Adjuster is responsible for managing moderate to complex and high-value casualty claims with minimal supervision.
• This role requires advanced investigative and negotiation skills to effectively resolve disputes and handle escalated situations.
• The Consultant works closely with internal and external experts, including legal counsel and technical specialists, to ensure thorough claim evaluation and resolution.

Key Responsibilities

• Include representing the company in various forums related to claims litigation, maintaining a high standard of professionalism, and ensuring compliance with regulatory and company standards.
• The role demands strategic thinking, sound judgment, and the ability to navigate sensitive and high-impact claim scenarios.

In This Role, You Will

• Independently manage moderate to complex, high-value casualty claims, ensuring thorough analysis and resolution.
• Lead thorough investigations, assess coverage, and issue appropriate documentation including reservation of rights and coverage letters. Escalate issues as needed.
• Identify opportunities to transfer risk and pursue subrogation.
• Proactively resolve disputes, deescalate sensitive situations, and ensure optimal claim outcomes through strategic negotiation and litigation management.
• Ensure all claims activities comply with regulatory and company standards.
• Maintain accurate, detailed records and prepare comprehensive reports.
• Execute jurisdictional compliance requirements and support others in understanding regulatory obligations.
• Set reserves, authorize payments, and make financial decisions within authority.
• Demonstrate strong financial acumen and contribute to reserving accuracy and efficiency.
• Coordinate with internal and external stakeholders including legal, underwriting, vendors, and agents. Lead cross-functional meetings and communicate complex information clearly to diverse audiences.
• Use advanced tools and analytics to identify trends, correct inconsistencies, and improve claims handling efficiency.
• Ensure proper data ingestion, labeling, and protection of personally identifiable information (PII).
• Serve as a mentor to junior claim handlers, providing guidance on complex claims, compliance, and litigation processes.
• Support training initiatives and contribute to the development of best practices and educational materials.

What You Need To Apply

• Bachelor s degree preferred, or a combination of education and equivalent experience.
• 5 10+ years of workers compensation claims handling experience with an insurance carrier.
• Must possess or obtain and maintain appropriate state adjuster licenses and continuing education credits.
• Skilled in negotiating complex claims and developing strategies to influence outcomes.
• Demonstrates sound judgment and decision-making on high-exposure cases, including litigation and compliance matters.
• Communicates clearly and effectively in both verbal and written formats across a variety of situations.
• Selects appropriate communication channels and consistently demonstrates empathy toward all stakeholders.
• Highly organized with the ability to manage complex workflows and participate in project work. Demonstrates strong time management and desk management skills, and mentors others in these areas.
• Possesses in-depth understanding of the regulatory environment and jurisdictional requirements. Handles complex compliance issues and mentors others on regulatory standards.
• Provides exceptional, empathetic customer service. Effectively manages escalated claims and sensitive customer concerns with professionalism and clarity.
• Ability to use a personal computer and other standard office equipment.
• Ability to sit and/or stand for extended periods.
• Required to work on-site as needed.
• Ability to travel as necessary.
• Ability to work in a fast paced, changing or stressful environment.
• Ability to perform work in a noisy/loud work environment.
• May be required to have and maintain sufficient home-based internet connection.

TekWissen Group is an equal opportunity employer supporting workforce diversity.