Senior Claims Examiner (Workers’ Comp) | High-Authority Role | Complex Claims
California (Remote/Hybrid options available)
Looking for more than just another claims desk? This is a high-ownership, high-impact role built for experienced professionals who thrive on complex claims, decision-making authority, and autonomy.
Join a leading third-party administrator (TPA) known for delivering top-tier workers’ compensation and risk management solutions. You’ll step into a client-facing, fast-paced environment where your expertise directly impacts outcomes.
Manage a full-cycle caseload (150–180 claims) including complex indemnity files
Investigate claims and determine compensability
Administer benefits in line with CA regulations and guidelines
Oversee medical treatment plans and authorize services
Partner with defense counsel on litigated claims
Set and manage claim reserves within authority
Negotiate and settle claims independently
Maintain accurate documentation and provide client updates + insights
Active California SIP Certification (Self-Insurance Plans)
5+ years of Workers’ Compensation Claims experience
Strong knowledge of California Workers’ Comp laws and regulations
Experience handling complex indemnity claims
Ability to manage a high-volume caseload independently
Excellent communication, negotiation, and analytical skills
Not an entry-level role — full ownership of complex files
Decision-making authority within your desk
Exposure to high-level, litigated claims
Work with a respected, high-performing TPA
Opportunity to grow and be recognized
If you have your CA SIP certification and are ready to take ownership of complex claims, this is a strong next step in your career.
Email your resume today !!
mpalkin@teemagroup.com