Senior Workers’ Compensation Indemnity Claims Adjuster | Remote

Our client is seeking an experienced Workers’ Compensation Claims Examiner to join their team. This position will be responsible for managing California workers’ compensation claims from initial assignment through final resolution, including indemnity claims involving lost time, medical treatment, litigation, and other complex claim-related matters. 

The ideal candidate will have strong California workers’ compensation knowledge, experience independently managing a claim inventory, and the ability to communicate effectively with injured employees, medical providers, attorneys, and other involved parties. Candidates must reside in Fresno, CA, or the surrounding area.

Responsibilities

• Manage a caseload of California workers’ compensation claims from initial reporting through closure.

• Investigate new claims, evaluate compensability, and determine appropriate benefits in accordance with California workers’ compensation regulations.

• Calculate and issue temporary disability, permanent disability, and other applicable indemnity benefits.

• Review medical documentation, treatment recommendations, work restrictions, and disability status to determine appropriate claim activity.

• Coordinate with injured employees, employers, medical providers, attorneys, and other parties throughout the life of the claim.

• Establish appropriate reserves and regularly evaluate claim exposure based on medical, legal, and financial developments.

   

Qualifications

• Minimum of 3 years of workers’ compensation claims adjusting or examining experience.

• Strong knowledge of California workers’ compensation laws, regulations, and claims-handling requirements.

• Experience handling claims from initial investigation through litigation and final closure.

• Previous experience within a self-insured environment is highly preferred.

• California Self-Insurance Administrator’s Certificate is required, or the ability to obtain the certification within the required timeframe.

• Strong understanding of indemnity benefits, medical management, reserving, litigation, and settlement practices.

Salary & Benefits

• $90,000–$110,000 (based on experience)

• Comprehensive medical, dental, and vision insurance.

• Employer-sponsored retirement benefits.

• Paid vacation, sick leave, and holidays.

• Employer-provided life insurance.