Senior Workers Compensation Claims Examiner

Acrisure

Bakersfield (CA)

Remoto

USD 90.000 - 110.000

Tempo pieno

37 ore fa

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Vantaggi offerti da questo lavoro

Medical insurance

Dental and Vision

401(k) plan

HSA/FSA

Paid time off

Wellness resources

EAP

Calm app

Commuter benefits

Descrizione del lavoro

The position demands strong analytical, negotiation, and communication skills to support claims, collaborate with defense counsel, and guide settlements while ensuring compliance with California

Competenze

Must have 5+ years of experience handling California workers' compensation claims.
Experience handling indemnity claims and litigated files is required.
Active California Adjuster Certification or OSIP/SIP self-insured qualification or CWCP designation is required.

Mansioni

Independently manage a caseload of California workers' compensation claims from assignment through resolution.
Investigate claims, evaluate compensability, and determine appropriate handling strategies.
Review coverage, liability, medical documentation, and claim exposure per California regulations.
Establish and manage reserves based on exposure and developments.
Manage complex indemnity claims, including litigated files and settlements.
Coordinate with defense counsel, medical providers, employers, and stakeholders throughout the process.
Monitor progress, maintain diaries, and ensure timely follow-up on all files.
Coordinate return-to-work efforts to support positive outcomes.
Identify fraud, subrogation, and cost containment opportunities when appropriate.
Maintain complete and timely documentation in the claims system.

Conoscenze

California WC knowledge

Indemnity claims

Litigated claims

Adjuster certification

Communication skills

Formazione

High school diploma

Strumenti

Claims management systems

Microsoft Office

Descrizione del lavoro

About Acrisure

A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services – and more.

Job Description

In the last twelve years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries. Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible.

Job Summary

Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This role is responsible for investigating claims, determining compensability, managing litigation, evaluating exposure, and developing claim resolution strategies while ensuring compliance with California workers' compensation laws and regulations.

Candidates must have direct, hands-on experience handling California workers' compensation claims. An active California Adjuster Certification, experience handling self-insured claims through the California Office of Self-Insurance Plans (OSIP/SIP), or a Certified Workers' Compensation Professional (CWCP) designation is required.

This is a fully remote position. Candidates must be able to support California-based claims and work business hours aligned with Mountain or Pacific Time zones.

Responsibilities

Independently manage a caseload of California workers' compensation claims from assignment through resolution
Investigate claims, evaluate compensability, and determine appropriate claim handling strategies
Review coverage, liability, medical documentation, and claim exposure in accordance with California regulations
Establish and manage reserves based on claim exposure and ongoing developments
Manage complex indemnity claims, including litigated files and settlement negotiations
Coordinate with defense counsel, medical providers, employers, and other stakeholders throughout the claims process
Monitor claim progress, maintain accurate diaries, and ensure timely follow-up on all assigned files
Coordinate return-to-work efforts and support positive claim outcomes
Identify fraud, subrogation, and cost containment opportunities when appropriate
Maintain complete, accurate, and timely documentation within the claims management system
Provide guidance and claim recommendations on complex files as needed
Perform additional duties and projects as assigned

Requirements

5+ years of experience handling California workers' compensation claims required
Experience managing indemnity claims required
Experience handling litigated workers' compensation claims required
Current California Adjuster Certification, OSIP/SIP self-insured qualification, or Certified Workers' Compensation Professional (CWCP) designation required
Strong knowledge of California workers' compensation laws, regulations, and claims handling practices
Experience developing claim resolution strategies and negotiating settlements
Ability to independently manage complex claims with minimal supervision
Strong analytical, decision-making, and problem-solving skills
Excellent verbal and written communication skills
Strong organizational skills with the ability to manage multiple priorities in a remote environment
Proficiency with Microsoft Office and claims management systems

Education and Licenses

High school diploma or equivalent required
Additional education beneficial
Current California Adjuster Certification, OSIP/SIP self-insured qualification, or Certified Workers' Compensation Professional (CWCP) designation required

Pay Details

The base compensation range for this position is $90,000 - $110,000. This range reflects Acrisure's good faith estimate at the time of this posting. Placement within the range will be based on a variety of factors, including but not limited to skills, experience, qualifications, location, and internal equity.

Candidates should be comfortable with an on-site presence to support collaboration, team leadership, and cross-functional partnership.

Why Join Us

At Acrisure, we’re building more than a business, we’re building a community where people can grow, thrive, and make an impact. Our benefits are designed to support every dimension of your life, from your health and finances to your family and future.

Making a lasting impact on the communities it serves, Acrisure has pledged more than $22 million through its partnerships with Corewell Health Helen DeVos Children's Hospital in Grand Rapids, Michigan, UPMC Children's Hospital in Pittsburgh, Pennsylvania and Blythedale Children's Hospital in Valhalla, New York.

Employee Benefits

We also offer our employees a comprehensive suite of benefits and perks, including:

Physical Wellness: Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time.
Mental Wellness: Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription.
Financial Wellness: Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs.
Family Care: Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage.
… and so much more!

This list is not exhaustive of all available benefits. Eligibility and waiting periods may apply to certain offerings. Benefits may vary based on subsidiary entity and geographic location.

Acrisure is an Equal Opportunity Employer. We consider qualified applicants without regard to race, color, religion, sex, national origin, disability, or protected veteran status. Applicants may request reasonable accommodation by contacting leaves@acrisure.com.

Final candidates will be required to complete post-offer verification processes related to the role and in accordance with applicable laws.

California Residents

Learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy.

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