Sr Adjuster WC - CA.

TekWissen LLC

Roseville (CA)

On-site

USD 110,000 - 170,000

Full time

11 days ago
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Job summary

TekWissen LLC seeks a Senior Workers’ Compensation Adjuster for California, onsite in Roseville. You will independently manage complex, high-value claims, lead investigations, assess coverage, and communicate with legal and underwriting teams to resolve matters efficiently.

Ideal candidates have 5–10+ years of WC claims experience, CA adjuster licensure, and strong negotiation and regulatory knowledge. This role requires excellent judgment, documentation, and mentorship of junior staff.

Qualifications

  • Bachelor's degree preferred or equivalent experience.
  • 5-10+ years of workers' compensation claims handling with an insurer.
  • Must possess or obtain and maintain state adjuster licenses.
  • Skilled in negotiating complex claims and strategies.
  • Demonstrates sound judgment on high-exposure cases including litigation.

Responsibilities

  • Independently manage moderate to complex, high-value casualty claims.
  • Lead investigations, assess coverage, and issue reservation of rights/coverage letters.
  • Identify opportunities to transfer risk and pursue subrogation.
  • Resolve disputes, deescalate situations, and negotiate for favorable outcomes.
  • Ensure all claims activities comply with regulatory and company standards.
  • Maintain accurate records and prepare comprehensive reports.
  • Coordinate with legal, underwriting, vendors, and agents; lead cross-functional meetings.
  • Utilize analytics to identify trends and improve handling efficiency.

Skills

Claims handling
Negotiation
Regulatory knowledge
Stakeholder communication
Mentoring

Education

Bachelor's degree (preferred)

Job description

Overview:

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

Job Title: Sr Adjuster WC - CA.
Work Location:

Roseville, CA 95661

Job Type: Full time
Work Type: Onsite
Duration: Full time
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.

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