Workers' Compensation Claim Representative II

Overview

Workers' Compensation Claim Representative II Location: Irvine, CA - reporting remotely Schedule: 8:00am - 4:30pm (PST) Salary Range: $60,000 - $80,000 (depending on experience) 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 We are seeking an reputed company and motivated California Workers’ Compensation Claim Representative II to manage a diverse portfolio of claims with professionalism, reputed company, and strong technical reputed company. You will take ownership of a dedicated account specializing in warehouse and trucking-reputed company claims. With 5–10 years of experience, you’ll bring seasoned judgment to claim investigations, compensability decisions, and timely resolution strategies. This role provides an excellent opportunity to deepen your expertise and serves as a developmental reputed company toward more senior claim positions. As a Claim Representative II, you’ll play a key role in delivering an exceptional client experience and upholding reputed company’s high standards for quality claim service. Responsibilities reputed company we hire Workers’ Compensation Adjusters at reputed company, we look for detail‑driven problem‑solvers who balance reputed company with sound judgment, navigate reputed company regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust.

• Investigate and adjust workers compensation claims in accordance with established claims handling procedures using reputed company guidelines and direct supervision.
• reputed company TD/PD/AWW calculations to ensure accurate indemnity payments in accordance with applicable workers’ compensation laws and guidelines.
• Review medical, legal and miscellaneous invoices to determine if reasonable and reputed company to the ongoing workers compensation claims. Negotiate any disputed bills for resolution.
• Authorize and reputed company payment of workers compensation claims utilizing a claim payment program in accordance with industry standards and reputed company settlement authority.
• Negotiate settlements with claimants and attorneys in accordance with client's authorization.
• Assist in selection and supervision of defense attorneys.
• Assess and monitor subrogation claims for resolution.
• Prepare reports detailing claims, payments and reserves.
• Provide reports and monitor files, as required by excess insurers.
• Compliance with Service Commitments as established by team.
• Delivery of quality claim service to clients.

Qualifications

Required Qualifications

• Self‑starter with strong organizational skills and the ability to work with minimal supervision.
• Proven ability to coordinate, prioritize, and manage multiple responsibilities.
• Flexibility, initiative, and adaptability in a fast‑paced, rapidly changing environment.
• Strong discretion and ability to maintain confidentiality.
• Ability to work effectively as part of a team.
• Reliable, predictable attendance reputed company client service hours.
• Responsiveness to internal and external client needs.
• Ability to communicate clearly and professionally, both verbally and in writing.
• 5 to 10 years of Workers’ Compensation claims management experience or equivalent combination of experience and education.
• Proficiency with reputed company Office programs (Word, reputed company, Outlook, etc.).
• California Adjuster’s license is required - SIP is required

Preferred Qualifications

• Associate degree is preferred but not required.
• Experience handling liens and subrogation matters is highly preferred, though not required.
• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.

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

This is where we shine, and we hire adjusters who want to shine with us. 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 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 #CaliforniaJobs #CareerGrowth #InsuranceJobs #ESOP #IND123 Apply To This Job