Sr California Workers Compensation Adjuster

Hanover Insurance Group, Inc.; Roseville (CA); Hybrid; USD 90.000 - 130.000; Vollzeit

Zusammenfassung

Hanover Insurance Group, Inc. seeks a Senior Workers' Compensation Adjuster for the California team. This full-time, exempt role manages moderate to complex, high-value casualty claims with minimal supervision, requiring advanced investigative and negotiation skills.

The position emphasizes regulatory compliance, reserving, and cross-functional collaboration with legal counsel, underwriting, and vendors. It offers a remote schedule with on-site work as needed and opportunities to mentor junior

Qualifikationen

• Bachelor’s degree preferred, or 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.
• Communicates clearly and effectively across a variety of situations; demonstrates empathy toward stakeholders.
• Highly organized with the ability to manage complex workflows and mentor others in these areas.
• Understanding of regulatory environment and jurisdictional requirements; handles complex compliance issues.
• Provides exceptional, empathetic customer service in escalated claims.
• Ability to work with a PC and standard office equipment; sit/stand for extended periods.
• On-site work as needed; travel as necessary.

Aufgaben

• Independently manage moderate to complex, high-value casualty claims; lead investigations and assess coverage; issue documentation including reservation of rights and letters.
• Identify opportunities to transfer risk and pursue subrogation; negotiate and manage litigation strategies.
• Ensure all claims activities comply with regulatory and company standards; maintain detailed records and prepare reports.
• Set reserves, authorize payments, and make financial decisions within authority.
• Coordinate with internal and external stakeholders including legal, underwriting, vendors, and agents; lead cross-functional meetings.
• Use advanced tools and analytics to identify trends and improve claims handling; protect PII.
• Mentor junior claim handlers and contribute to training and best practices.

Kenntnisse

Negotiation

Regulatory compliance

Mentorship

Communication

Project management

Investigations

Ausbildung

Bachelor’s degree preferred

Jobbeschreibung

Our Workers Compensation Lost Time Claims department is seeking a Senior Workers Compensation Adjuster for the California team. This is a Full-time/Exempt role with a fully remote schedule.

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.

This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.