Senior Workers' Compensation Examiner

King's Insurance Staffing; Fresno (CA); On-site; USD 90,000 - 110,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Employer-sponsored retirement benefits

Paid vacation, sick leave, and olidays

Job summary

King's Insurance Staffing has a client in Fresno, CA seeking an experienced Workers' Compensation Claims Examiner to manage California claims from assignment to resolution.

The ideal candidate will have 3+ years of CA workers' compensation claims experience, strong knowledge of CA regulations, and the ability to communicate with injured employees, providers, and attorneys. This on-site role offers a $90,000-$110,000 salary plus comprehensive benefits.

Qualifications

• Minimum of 3 years of workers' compensation claims adjusting or examining experience.
• Strong knowledge of California workers' compensation laws, regulations, and claims-handling requirements.
• Experience handling claims from initial investigation through litigation and final closure.
• Previous experience within a self-insured environment is highly preferred.
• California Self-Insurance Administrator's Certificate is required, or the ability to obtain the certification within the required timeframe.
• Strong understanding of indemnity benefits, medical management, reserving, litigation, and settlement practices.

Responsibilities

• Manage a caseload of California workers' compensation claims from initial reporting through closure.
• Investigate new claims, evaluate compensability, and determine appropriate benefits in accordance with California workers' compensation regulations.
• Calculate and issue temporary disability, permanent disability, and other applicable indemnity benefits.
• Review medical documentation, treatment recommendations, work restrictions, and disability status to determine appropriate claim activity.
• Coordinate with injured employees, employers, medical providers, attorneys, and other parties throughout the life of the claim.
• Establish appropriate reserves and regularly evaluate claim exposure based on medical, legal, and financial developments.

Skills

California workers' compensation laws

Claim inventory management

Stakeholder communication

Education

California Self-Insurance Administrator's Certificate

Job description

Our client is seeking an experienced Workers' Compensation Claims Examiner to join their team. This position will be responsible for managing California workers' compensation claims from initial assignment through final resolution, including indemnity claims involving lost time, medical treatment, litigation, and other complex claim-related matters.

The ideal candidate will have strong California workers' compensation knowledge, experience independently managing a claim inventory, and the ability to communicate effectively with injured employees, medical providers, attorneys, and other involved parties. Candidates must reside in Fresno, CA, or the surrounding area.

Responsibilities

• Manage a caseload of California workers' compensation claims from initial reporting through closure.
• Investigate new claims, evaluate compensability, and determine appropriate benefits in accordance with California workers' compensation regulations.
• Calculate and issue temporary disability, permanent disability, and other applicable indemnity benefits.
• Review medical documentation, treatment recommendations, work restrictions, and disability status to determine appropriate claim activity.
• Coordinate with injured employees, employers, medical providers, attorneys, and other parties throughout the life of the claim.
• Establish appropriate reserves and regularly evaluate claim exposure based on medical, legal, and financial developments.

Qualifications

• Minimum of 3 years of workers' compensation claims adjusting or examining experience.
• Strong knowledge of California workers' compensation laws, regulations, and claims-handling requirements.
• Experience handling claims from initial investigation through litigation and final closure.
• Previous experience within a self-insured environment is highly preferred.
• California Self-Insurance Administrator's Certificate is required, or the ability to obtain the certification within the required timeframe.
• Strong understanding of indemnity benefits, medical management, reserving, litigation, and settlement practices.

Salary & Benefits

• $90,000-$110,000 (based on experience)
• Comprehensive medical, dental, and vision insurance.
• Employer-sponsored retirement benefits.
• Paid vacation, sick leave, and holidays.