Workers Compensation Claims Adjuster I

Intercareins; Rocklin (CA); On-site; USD 52,000 - 75,000; Full time

Benefits offered by this job

Comprehensive medical, dental, and vision benefits

401(k) with company match

Paid time off (PTO)

Learning and development opportunities

Employee assistance resources

Job summary

A leading risk management organization is looking for a Workers' Compensation Claims Assistant to analyze claims, determine insurance liability, and manage settlements. This role requires problem-solving skills, a customer-focused attitude, and collaboration within a team. Candidates should have at least 1-3 years of experience in workers' compensation or be a recent graduate with relevant coursework. Comprehensive benefits and opportunities for career advancement are provided, fostering a supportive work environment.

Qualifications

• 1-3 years experience as a Workers’ Compensation Claims Assistant.
• Up to one year Trainee or Future Med Adjuster experience.
• Ability to perform essential duties satisfactorily.

Responsibilities

• Analyze insurance claims to determine liability.
• Negotiate and finalize claim settlements.
• Work independently in a fast-paced environment.
• Prepare claims status reports to carriers at 90-day intervals.
• Manage medical care strategies to maintain medical control and intervene when appropriate.
• Identify and rate permanent disability and manage subrogation issues.

Skills

Problem Solving

Customer Service

Interpersonal

Team Work

Education

Bachelor’s degree (B.A.)

Job description

Description

AvonRisk is the nation’s leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers’ compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals and brands including Intercare, InterMed, George Hills, and AS&G Claims Administration, we’re a people-focused, operations-driven organization that prioritizes reasonable caseloads, strong training, collaborative teams, and expert support. We invest in tools and workflows that reduce friction—not increase volume—and create real career paths for professionals who want to grow their careers or move into leadership. At AvonRisk, you’re part of a team that values good judgment, curiosity, and accountability, and gives you the support to succeed.

Summary

Under close supervision, analyzes insurance claims to determine extent of insurance carrier's liability and settles claims with claimants in accordance with policy provisions by performing the following duties.

Essential Duties and Responsibilities

• Three-point contact, initial investigation, initial benefit determination.
• Ability to identify and address questionable (AOE/COE) claims.
• Establish and monitor reserves at periodic intervals.
• Prepare claims status report to carriers at 90-day intervals.
• Ability to manage and direct medical care, including strategies to maintain medical control and objection when appropriate.
• Identify and rate permanent disability.
• Vocational Rehabilitation file management
• Negotiate and finalize claim settlements as well as lien settlements.
• Identify and manage subrogation issues on workers’ compensation claims.
• Work independently and in a fast paced environment.

Requirements

Competency

• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Interpersonal - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
• Team Work - Supports everyone's efforts to succeed.

Qualification Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

At least 1-3 years experience as a Workers’ Compensation Claims Assistant, or up to one year Trainee or Future Med Adjuster experience; or Bachelor’s degree (B.A.) and six months experience.

The salary range listed is an estimate. Actual compensation will be determined based on several factors such as a candidate’s experience, qualifications, skill set, and work location.

Benefits

• Comprehensive medical, dental, and vision benefits
• Company contributions to HSA and FSA plans
• Employer paid life and disability insurance
• 401(k) with company match
• Paid time off (PTO) and company paid holidays
• Learning and development opportunities that support real career advancement
• Employee assistance resources and a supportive culture that values balance and wellbeing

We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.