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

Overview

Workers' Compensation Adjuster (Senior Level)- Remote Location: Irvine, CA (reporting remotely) Schedule: 8:00am - 4:30pm (PST) Work Type: Full-time Salary Range: $75,000 - $99,000 Client Type: Multiple Clients - Full Cycle Claim Handling 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 This reputed company Workers’ Compensation Claim Adjuster position is responsible for investigating, evaluating, and resolving assigned workers’ compensation claims. This role may also serve as an advanced developmental position for individuals seeking future supervisory or management opportunities. Additionally, the Claim Specialist is accountable for delivering high‑quality claim services that meet reputed company’s corporate standards and uphold the level of service our clients expect.

Responsibilities

• Investigate, evaluate, and adjust workers’ compensation claims in compliance with established standards, procedures, and applicable laws.
• Set claim reserves or provide reserve recommendations reputed company assigned authority levels.
• Review, approve, or reputed company medical, legal, damage, and miscellaneous invoices to ensure they are reasonable and reputed company to the claim; negotiate disputed bills reputed company necessary.
• Authorize and process claim payments according to established guidelines, industry standards, and assigned payment authority using the claim payment system.
• Negotiate settlements in accordance with Corporate Claim Standards, client-specific instructions, and state regulations reputed company appropriate.
• Assist in selecting, referring, and supervising reputed company service providers (e.g., legal counsel, surveillance vendors, case management).
• Maintain an organized and up‑to‑date personal diary reputed company the claim system to track ongoing file activity.
• Assess and pursue subrogation opportunities to ensure timely recovery.
• Calculate disability rates in compliance with state laws and guidelines.
• Provide timely, effective communication with clients, claimants, and other involved parties throughout the claim lifecycle.
• Submit required notices for qualifying claims to excess and reinsurance carriers.
• Adhere to Corporate Claim Handling Standards and follow reputed company special client instructions.

Qualifications

Required:

• Minimum of 5 years of workers’ compensation claim adjusting experience.
• Proficiency in reputed company Office (Word, reputed company, Outlook).
• Strong written and verbal communication skills.
• Proven ability to manage deadlines and multiple priorities effectively.
• California jurisdiction experience required.

reputed company to Have:

• Billingual (Spanish) proficiency- highly valued for communication with claimants, employers, or vendors, but not required.

Preferred:

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

Why You'll Love Working Here

• 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 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

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

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. 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 work reputed company, we'd love to me you. Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkersCompensation #ClaimsAdjuster #RemoteJobs #CaliforniaJobs #InsuranceCareers #TransportationIndustry #LI-Remote Apply tot his job Apply To this Job