Workers' Compensation Claims Representative

Remote Workers Compensation Claims Adjuster (CA)

A leading insurance organization is seeking a seasoned Workers Compensation Claims Adjuster to join its team. This is a fully remote opportunity available to candidates located anywhere within the continental United States.

Key Responsibilities

• Assess and determine compensability and coverage for lost time workers compensation claims.
• Manage a diverse caseload across multiple jurisdictions with efficiency and attention to detail.
• Negotiate settlements and direct resolution strategies within established authority levels.
• Collect and analyze medical documentation and factual evidence to support claim decisions.
• Oversee external investigations and manage litigated files.
• Maintain consistent communication with claimants, attorneys, investigators, medical providers, and internal stakeholders.

Qualifications

• Minimum of 3 years of experience in workers compensation claims adjusting.
• Proven experience handling California claims; SIP certification is required.
• Bachelor's degree is mandatory.
• Prior experience with insurance carriers is preferred.
• Strong background in managing lost time and litigated claims.
• Solid understanding of medical terminology.
• Exceptional organizational, analytical, negotiation, and conflict resolution skills.
• Excellent written and verbal communication abilities.