Senior Workers' Compensation Claims Specialist

City of Sacramento; Sacramento (CA); Hybrid; USD 70,000 - 95,000; Full time

Job summary

City of Sacramento seeks a Workers' Compensation Claims Representative to manage the full claims lifecycle under California law. The role requires coordination with employees, departments, medical providers, and legal entities to ensure timely benefits and return-to-work solutions.

Ideal candidates will have three years of workers' compensation experience, an associate degree or equivalent, and relevant certification.

Qualifications

• Three years of Workers' Compensation claims adjusting experience.
• Associate degree or 60 semester units from an accredited college or university.
• Certification: Experienced Claims Examiner or equivalent required by appointment and licensing regulations.

Responsibilities

• Review accident/injury reports and medical forms to determine actions under CA Workers' Compensation laws.
• Establish and maintain monetary reserves for medical and related costs; prepare settlements when appropriate.
• Process and pay benefits, review medical bills, and defend claims when needed.
• Coordinate return-to-work and communication among injured employees, departments, and providers.
• Attend settlement conferences, hearings, and related meetings; provide exceptional customer service.

Skills

Analytical

Communication

Problem solving

Education

Associate degree or 60 sem. units

Tools

Claims software

MS Office

Job description

City of Sacramento seeks a Workers' Compensation Claims Representative to manage the full claims lifecycle under California law. The role requires coordination with employees, departments, medical providers, and legal entities to ensure timely benefits and return-to-work solutions.

Ideal candidates will have three years of workers' compensation experience, an associate degree or equivalent, and relevant certification.