Workers' Compensation Claims Examiner III - Glendale, CA OR Orange, CA (Contract - Hybrid)

Johnson Service Group, Inc.; California (MO); Híbrido; USD 65.000 - 88.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical insurance

Dental insurance

Vision insurance

Life insurance

Short-term disability

401(k)

Weekly pay

Descripción de la vacante

Johnson Service Group seeks a Workers’ Compensation Claims Adjuster III for a hybrid role based near Glendale, CA or Orange, CA. You will handle the most complex, high-exposure claims and provide technical guidance to clients, carriers, and colleagues.

With 7+ years in WC claims and strong PD rating knowledge, you will mentor junior staff, oversee settlements and multi-party liens, and coordinate with medical and legal teams.

Formación

• 7+ years WC claims experience with independent indemnity management.
• Strong knowledge of PD rating, MSA, and multi-party liens.
• Bachelor’s degree or equivalent combination required.

Responsabilidades

• Conduct complex investigations for high-exposure claims and strategize resolutions.
• Lead medical management including coordinating UR/IMEs and life care planners.
• Manage litigation processes, selecting counsel and guiding settlements and trial prep.
• Oversee settlements, lien resolution, and subrogation efforts across multi-party files.
• Provide technical leadership and mentor junior adjusters; maintain client relations.

Conocimientos

Mentoring junior adjusters

Client relationship management

PD rating expertise

Litigation coordination

Educación

Bachelor's degree in related field

Herramientas

MS Office

Claims management systems

Descripción del empleo

Workers' Compensation Claims Examiner III - Glendale OR Orange, CA (Contract - Hybrid) Pay Rate: 55.55 Position is hybrid 3 days in office in either Glendale, CA or Orange, CA

Role Summary

As a Workers’ Compensation Claims Adjuster III at, you are a senior technical expert trusted with the organization’s most complex, high-exposure, and strategically sensitive claims—including catastrophic injuries, multi-party litigation, and cases with novel legal or medical challenges. You provide technical guidance and supervisory backup to your unit and serve as a senior resource for clients, carriers, and colleagues.

Location & Work Arrangement

Position can be hybrid but prefer candidates within a commutable distance of Glendale, CA or Orange, CA.

Essential Duties & Responsibilities

Complex Claims Investigation & Compensability Perform three-point contact on all new losses and apply heightened scrutiny to complex, catastrophic, and high-exposure cases; maintain detailed plans of action with strategic resolution planning on all assigned indemnity files. Identify fraud indicators and refer to SIU with advanced pattern recognition; gather and document case facts on files involving multi-party liability, catastrophic injury, significant subrogation potential, or novel legal issues.

Medical Management, RTW & Vocational Rehabilitation Lead medical management on catastrophic and high-complexity claims including directing specialists, coordinating life care planners, directing UR and IMEs, and managing PTD cases. Partner with case managers to maximize early RTW; review medical bills for appropriateness on high-cost and unusual treatment patterns.

Permanent Disability, Reserving & Financial Stewardship Lead PD rating on complex cases including significant apportionment, overlapping injuries, and disputed ratings; establish and adjust reserves on high-exposure files with precision and clear documented justification. Ensure status reports are submitted in compliance with the reporting timelines and formats outlined in individual client instructions.

Litigation Management Independently direct the full litigation process on the unit’s most complex files including selecting defense counsel, setting strategy, retaining experts, managing legal spend, and preparing for trial. Lead mediations, settlement conferences, and arbitrations; make or recommend high-value settlement authority decisions in coordination with the Claims Supervisor and client.

Settlements, Lien Resolution & Recovery Independently negotiate and finalize high-value settlements including C&R and Stipulated Awards; manage multi-lien resolution (MSA, Medi-Cal, provider, attorney liens) and coordinate with lien counsel and CMS as required. Aggressively pursue subrogation, multi-defendant contribution, and apportionment recovery; coordinate with recovery vendors and outside subrogation counsel on high-value opportunities.

Technical Leadership & Supervisory Backup Serve as technical backup for the Claims Supervisor; provide guidance on complex decisions, reserve adequacy, and escalated client issues; mentor Adjuster I and II colleagues and support unit-wide quality review. Serve as a senior point of contact for key client accounts on complex or escalated matters; maintain client and carrier relationships with professionalism and technical authority.

Professionalism & Communication Maintain proactive, transparent communication with all stakeholders; respond within required timeframes and project a professional, expert image in all interactions.

Qualifications

Education & Experience Minimum 7 years of WC claims experience including at least 5 years of independent indemnity management with expertise in complex, high-exposure, and litigated files; OR Bachelor’s degree and a minimum of 5 years of WC indemnity experience at an independent level; OR equivalent combination.

Comprehensive knowledge of public entity liability claims including JPAs, self-insured programs, and pooled insurance arrangements.

Licenses & Certifications CA SIP certificate required. Professional designations such as AIC, ARM, WCCP, or CPCU a plus but not required.

Technical & Subject Matter Expertise Deep expertise in applicable state WC statutes; California statute mastery strongly preferred. Multi-jurisdiction experience highly valued. Direct experience working within one or more claims administration or claims processing platforms commonly used in worker’s compensation/insurance claims handling. Demonstrated experience directing complex litigation through mediation, settlement conference, and trial preparation; advanced knowledge of PD rating, MSA requirements, and multi-party lien resolution. Experience with catastrophic injury management and life care planning coordination; familiarity with claims management platforms; proficiency in Microsoft Office.

Leadership & Interpersonal Skills Demonstrated ability to mentor junior adjusters and serve as a supervisory backup or senior technical resource. Strong client relationship management skills; experience handling escalated concerns at a senior level.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this role.

JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.