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Insurance Examiner

We help people like you find exciting roles with employers ranging from Fortune 100, government, and nonprofit organizations to local businesses, industry leaders, and the most agile start-ups. The ideal candidate will have extensive experience handling high-exposure claims, evaluating legal and medical aspects, and actively directing litigation strategies when necessary.

Salary

KBSkills

ACTIVE

<div> Senior Claims Examiner – Workers’ Compensation (Contract) You are an experienced Senior Claims Examiner who will manage a complex caseload of workers’ compensation claims. This role requires independent decision-making, strategic problem-solving, and proactive claims resolution to achieve optimal financial and operational outcomes. The ideal candidate will have extensive experience handling high-exposure claims, evaluating legal and medical aspects, and actively directing litigation strategies when necessary.</div><div style="font-weight:normal"> </div><div>This position pays: $38-$52 per hour</div><div style="font-weight:normal"> </div><div>Location: Roseville, CA What You Will Be Doing: <ul style="font-weight:normal"><li>Evaluate and manage claims from inception to resolution, ensuring timely and accurate processing.</li><li>Analyze medical, legal, and factual information to determine claim compensability.</li><li>Establish and adjust reserves for medical, legal, vocational, and indemnity costs based on case facts.</li><li>Strategize and direct legal counsel on claim litigation, including discovery, depositions, and settlement negotiations.</li><li>Oversee diaries, communications, payments, and required notices to drive claims toward timely resolution.</li><li>Negotiate and settle claims within designated authority levels.</li><li>Provide mentorship and training to team members, sharing best practices and industry knowledge.</li><li>Represent the company at depositions, hearings, and other legal proceedings as needed.</li><li>Ensure compliance with all state and regulatory requirements.</li></ul>What You Bring: <ul><li>High school diploma or GED required; Bachelor's degree preferred.</li><li>Minimum five (5) years of workers’ compensation claims handling experience.</li><li>Strong expertise in claims management, investigation, reserving, cost analysis, and resolution strategies.</li><li>Excellent organizational, analytical, and time management skills.</li><li>Ability to evaluate complex claim data and determine appropriate actions.</li><li>Proficiency in Microsoft Office and ability to learn industry-specific software.</li><li>Strong customer focus with exceptional attention to detail.</li><li>Ability to work independently while collaborating effectively with legal and medical professionals.</li><li>SIP License required (senior level).</li><li>Must meet ongoing training or experience requirements per California Code of Regulations.</li></ul>If you are a results-driven claims professional with a strategic mindset and a passion for resolving complex cases, we encourage you to apply! <div style="font-weight:bold">To learn more about the workplace culture and the position, please apply!</div>For over 50 years, Nelson Connects has empowered employers and job seekers to achieve their unique versions of success. Our commitment to excellence, integrity, compassion, and innovation has made us a trusted partner in connecting jobs, people, and communities. The remarkably talented and dedicated people of Nelson Connects are building on the rich history of this company to define the future of our industry, and we can’t wait to work with you. We are Nelson Connects, and our purpose is your success.#Pando#LI-RC1  </div> About Nelson Connects:If you're looking for a new opportunity, the recruiting and staffing experts at Nelson Connects can help. We work with companies of all types and sizes across all industries. We help people like you find exciting roles with employers ranging from Fortune 100, government, and nonprofit organizations to local businesses, industry leaders, and the most agile start-ups. The candidates we work with appreciate our responsive approach, genuine relationships, and exceptional service. With a commitment to transparency, authenticity, and credibility, we look forward to our jobs every day, and we're excited to help you find the job you've been looking for.Pay Transparency: Nelson Connects provides pay transparency by placing salary ranges in all job postings in accordance with state and local regulations. We are committed to communicating pay clearly throughout the employment process.California Fair Chance Act and Beyond: Qualified applicants with criminal histories will be considered for employment in accordance with applicable regulations. We will consider qualified Applicants for employment, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, San Francisco Fair Chance Ordinance, and CA Fair Chance Act.Temporary Associate Benefits Offered: Weekly benefits offered include Medical, Dental, Vision, HSA, EAP, Life/AD&D, STD, Commuter FSA, + state mandated benefits.EEO Statement: Nelson Connects is an equal-opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status, or any other classification protected by law.PandoLogic. Keywords: Insurance Examiner, Location: Fair Oaks, CA - 95628

Nelson Connects

Senior Claims Examiner – Workers’ Compensation

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Administrative Skills

Analysis Skills

Best Practices

Case Management

Claims Management

Claims Processing

Communication Skills

Cost Analysis

Customer Relations

Detail Oriented

Financial Operations

Government Organizations

High School Diploma

Industry-Specific Software

Insurance

Legal

Litigation

Maintain Compliance

Mentoring

Microsoft Office

Negotiation Skills

Nonprofit

Organizational Skills

Problem Solving Skills

Regulatory Requirements

SIP (Session Initiation Protocol)

Startup

State Laws and Regulations

Time Management

Training/Teaching

Pandologic

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