Senior Workers Compensation Claims Examiner

Acrisure; Modesto (CA); Remote; USD 90,000 - 110,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401(k) Plan

Paid Time Off

Job summary

Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. The role requires active CA Adjuster Certification or CWCP designation and hands-on experience with self-insured claims through OSIP/SIP.

This fully remote position supports California-based claims and aligns work hours with Mountain or Pacific Time zones.

Qualifications

• 5+ years of experience handling California workers' compensation claims.
• Experience managing indemnity and litigated claims.
• Current California Adjuster Certification or CWCP designation.
• Strong knowledge of California workers' compensation laws and practices.

Responsibilities

• Independently manage a caseload of California workers' compensation claims from assignment through resolution.
• Investigate claims, evaluate compensability, and determine handling strategies.
• Review coverage, liability, medical docs, and claim exposure per CA regulations.
• Establish and manage reserves based on exposure and developments.
• Coordinate with defense counsel, medical providers, employers, and stakeholders.
• Maintain diaries and ensure timely follow-up on all files.

Skills

CA workers' comp claims

Litigation handling

Adjuster Certification

OSIP/SIP qualification

CWCP designation

Microsoft Office

Claims management systems

Education

CA Certificate/licenses

High school diploma

Tools

Claims management software

Microsoft Office

Job description

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

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.

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

• 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 [e-mail].

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.