Workers' Compensation Claims Specialist

Jobtailor; Los Angeles (CA); Hybrid; USD 120,000 - 180,000; Full time

Job summary

Jobtailor seeks an experienced California Workers' Compensation Claims professional to lead investigation, evaluation, and resolution of complex CA claims. The role requires reviewing coverage and liability, analyzing reports and documents, and guiding settlements within authority.

The candidate will coordinate with legal and claims teams, mentor staff, and ensure compliance with laws and company policies. Hybrid work in Woodland Hills; remote options may be considered.

Qualifications

• Bachelor’s degree or equivalent experience required.
• 6–10 years of California Workers' Compensation claims handling.
• Ability to work under limited supervision.
• Hybrid schedule for Woodland Hills candidates; remote considered if not local.

Responsibilities

• Investigate and maintain workers’ compensation claims.
• Review and evaluate coverage and/or liability.
• Secure and analyze reports, policies, appraisals, releases, statements, records and other documents.
• Work toward resolution of claims files.
• Attend arbitrations, mediations, depositions or trials as necessary.
• Convey complex coverage decisions to appropriate parties.
• Ensure claims payments are issued timely and accurately.
• Ensure claims handling complies with statutes, regulations, company procedures and policies.
• Provide technical advice to lower-level positions and other functional areas.
• Coaching staff and participating in talent development decisions.
• Perform other duties as assigned.

Skills

CA Workers' Compensation Claims

Claims Evaluation

Settlement Negotiation

Compliance with Legal Requirements

Arbitration & Mediation

Coaching

Communication

Problem-Solving

Decision-Making

Collaboration

Education

Bachelor’s Degree or equivalent experience

Bachelor’s Degree in Liberal Arts, Business or related discipline

Job description

Investigate and maintain workers’ compensation claims
Review and evaluate coverage and/or liability
Secure and analyze reports, policies, appraisals, releases, statements, records, and other documents
Work toward resolution of claims files
Attend arbitrations, mediations, depositions, or trials as necessary
Affect settlements/reserves within prescribed limits and submit recommendations on cases exceeding personal authority
Convey complex coverage, decisions, and outcomes to appropriate parties
Ensure claims payments are issued timely and accurately
Ensure claims handling complies with statutes, regulations, legal requirements, company procedures, and policies
Provide technical advice to lower-level positions and other functional areas
Potentially coach staff and participate in talent selection, development, and performance management decisions
Perform other duties as assigned

Requirements

• Bachelor’s Degree or equivalent experience
• Bachelor’s Degree in Liberal Arts, Business or a related discipline
• Generally, 6 to 10 years of experience handling California Workers' Compensation Claims
• Specialized knowledge in highly complex claims assignments
• Ability to work under limited supervision
• Ability to provide technical advice to lower level positions and other functional areas
• Candidates local to the Woodland Hills office work on a hybrid schedule
• Remote candidates may be considered if not local to the office

Core Competencies

Demonstrates expertise in managing California Workers' Compensation Claims, including investigation, evaluation, and resolution of claims. Provides technical advice and coaching to staff while ensuring compliance with legal requirements and company policies.

Highest-signal resume keywords

• California Workers' Compensation Claims Management
• Claims Investigation and Resolution
• Technical Advice and Coaching
• Compliance with Legal Requirements
• Claims Payment Processing

Hard Skills

• Claims Evaluation
• Coverage Analysis
• Settlement Negotiation
• Document Analysis
• Claims Handling Procedures
• Statutory Compliance
• Liability Assessment
• Report Analysis
• Performance Management
• Arbitration and Mediation

Soft Skills

• Communication
• Problem-Solving
• Coaching
• Collaboration
• Decision-Making

Industry Keywords

• Workers' Compensation
• Claims Management
• Legal Compliance
• California Regulations
• Claims Processing