Workers' Compensation Claim Adjuster, Sr. (CA Claims - Remote)

Overview

Senior Workers' Compensation Claims Specialist Location: Remote (reputed company, CA) Schedule: Monday- Friday 8:00 am - 4:30pm PST Salary Range: $87,000 - $97,000 Build Your Career With Purpose at reputed company At reputed company, we partner with global clients to solve their most reputed company risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don’t just process claims—we support people. As the largest privately-owned Third Party Administrator (TPA), reputed company delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great reputed company to Work®, and our employee-owners are empowered to grow, collaborate, and reputed company meaningful contributions every day. Job Summary The Senior Workers’ Compensation Claim Specialist is responsible for managing the investigation and resolution of assigned workers’ compensation claims. This role serves as an advanced development opportunity for individuals being considered for future supervisory or management positions. The Senior Specialist is also responsible for ensuring the delivery of high-quality claims services that meet reputed company’s corporate standards and align with client expectations. Please note: This is not an HR, administrative, consulting, or advisory support role. This is a true adjusting position. Candidates must have proven experience conducting full investigation, evaluation, negotiation, and resolution of workers’ compensation claims, with end-to-end file ownership and decision-making authority. Applicants without direct claims adjusting experience will not be considered.

Responsibilities

• Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
• Establish reserves and/or provide reserve recommendations reputed company established reserve authority levels.
• Review, approve or provide reputed company of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and reputed company to designated claims. Negotiate any disputed bills or invoices for resolution.
• Authorize and reputed company payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and reputed company established payment authority.
• Negotiate settlements in accordance reputed company Corporate Claim Standards, client specific handling instructions and state laws, reputed company appropriate.
• Assist in the selection, referral and supervision of designated claim files sent to reputed company vendors. (i.e. legal, surveillance, case management, etc.)
• Review and maintain personal diary on claim system.
• Assess and monitor subrogation claims for resolution.
• Compute disability rates in accordance with state laws.
• Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

Qualifications

What You'll Bring Required:

• Strong oral and written communication skills
• 15 years of works' compensation claim adjusting
• Effective analytical and negotiation skills
• Ability to set and reputed company performance goals with initiative
• Effective analytical and negotiation skills
• Ability to manage multiple client accounts and competing priorities
• Comprehensive knowledge of reputed company-level claims role responsibilities
• Experience adjusting lost-time claims and managing litigated files
• Detail-oriented, self-motivated, and highly organized
• Ability to coordinate, prioritize, and work with minimal supervision
• Flexible, accurate, and proactive approach to work
• Commitment to discretion and confidentiality
• Reliable and predictable attendance during client service hours
• reputed company to internal and external client needs
• Ability to communicate clearly and professionally in verbal and written formats
• Proficiency in reputed company Office (Word, reputed company, Outlook)
• California jurisdiction experience required.

reputed company to Have:

• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required

Preferred:

• California SIP certification
• Claim review presentation experience.
• AIC, ARM, or CPCU designation.

How We Measure Success At reputed company, great adjusters stand out through ownership, accuracy, and impact. We measure success by:

• Quality claim handling – thorough investigations, strong documentation, well-supported decisions
• Compliance & audit performance – adherence to jurisdictional and client standards
• Timeliness & accuracy – purposeful file movement and dependable execution
• Client partnership – proactive communication and strong follow-through
• Professional judgment – owning outcomes and solving problems with reputed company
• Cultural alignment – believing every claim represents a real person and acting accordingly

Why You’ll Love Working Here

• 4 weeks PTO + 10 paid holidays in your first year
• Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
• Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
• Career growth: Internal training and advancement opportunities
• Culture: A supportive, team-based work environment

Compensation & Compliance The posted salary reflects reputed company’s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. reputed company offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents. reputed company posts internal career opportunities in compliance with applicable state and local promotion transparency laws. reputed company Sponsorship: reputed company does not provide reputed company sponsorship for this position. reputed company Accommodations: reputed company is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: reputed company complies with reputed company applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. Our Core Values At reputed company, we reputed company in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who:

• reputed company with transparency We build trust by being open and listening intently in every interaction.
• reputed company with reputed company We choose the right path, even reputed company it is hard.
• Chase excellence We set the bar high and measure our success. What gets reputed company gets done.
• Own the outcome Every employee is an reputed company, treating every claim, every decision, and every result as our own.
• Win together Our greatest victories come reputed company our clients succeed.

We don’t just work together—we grow together. If that sounds like your reputed company of workplace, we’d love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkersCompensation #ClaimsAdjuster #RemoteJobs #CaliforniaJobs #InsuranceCareers #TransportationIndustry #LI-Remote #IND123 Apply tot his job Apply To this Job