Best Practices, Calendar Management, Case Management, Claims Processing, Communication Skills, Documentation, Healthcare Providers, High School Diploma, Leadership, Litigation, Maintain Compliance, Medical Records, Negotiation Skills, Organizational Skills, Regulations, Strategic Planning, Time Management, Treatment Plan, Worker's Compensation
Our client, a highly respected A-rated Workers' Compensation carrier, is looking to add an experienced California Workers' Compensation Claims Examiner to join their growing team. This opportunity is ideal for a claims professional with a strong background handling complex California Workers' Compensation claims, including litigated lost-time exposures. The successful candidate will be comfortable managing a full caseload independently while partnering with employers, medical providers, attorneys, and internal stakeholders to drive claims toward successful resolution.
This is a fully remote opportunity, with preference given to candidates located in the Western United States.
Independently manage a caseload of approximately 90–100 California Workers' Compensation claims, including both lost-time and medical-only files
Investigate claims, evaluate compensability, and develop appropriate action plans while ensuring compliance with California Workers' Compensation regulations
Monitor and coordinate medical treatment plans in accordance with California guidelines and best practices
Handle litigated claims, collaborating closely with defense counsel to develop case strategy and move files toward resolution
Negotiate settlements and resolve disputes with claimants, attorneys, and other involved parties
Prepare and present complex or high-exposure claims to leadership when necessary
Maintain accurate claim documentation, diary management, and timely file activity
5-10+ years of California Workers' Compensation claims handling experience
Demonstrated experience managing lost-time claims and litigated files through closure
Thorough understanding of California Workers' Compensation statutes, WCAB procedures, and claims administration practices
Strong reserving, investigation, negotiation, and litigation management skills
Excellent communication, organizational, and decision-making abilities
High School Diploma required; Bachelor's Degree preferred
$100,000 - $115,000+ annual base salary, depending on experience and qualifications
Performance-based bonus opportunity
Medical, Dental, and Vision coverage
Generous Paid Time Off program
401(k) with company match
Fully remote work environment with scheduling flexibility
Long-term career growth opportunities with a stable, highly rated organization
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King'S Insurance Staffing