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Workers' Compensation Claims Examiner

L5

ultimate staffingSacramento, CAyesterday

$38.00 - $45.00 per hour

Occupations

Claims Adjusters, Examiners, and InvestigatorsCompensation, Benefits, and Job Analysis SpecialistsInsurance Claims and Policy Processing Clerks

Industries

Claims AdjustingTemporary Help ServicesAll Other Insurance Related Activities
Workers' Compensation Claims Examiner (Hybrid)
Location: Sacramento, CA
Schedule: Monday - Friday, 8:00 AM - 5:00 PM
Pay: $38.00 - $45.00 per hour
Work Arrangement: Hybrid
Employment Type: Full-Time
Workers' Compensation Claims Examiner experience is required. SIP experience is also required. Unfortunately, candidates without Workers' Compensation claims handling experience and SIP experience will not be considered for this opportunity. Join a Team That Values Expertise We are seeking an experienced Workers' Compensation Claims Examiner to manage a caseload of complex and litigated California workers' compensation claims. This hybrid opportunity is ideal for someone who can work independently, make sound claim decisions, and build strong relationships with clients, attorneys, medical providers, and other stakeholders.
What You'll Be Doing:
  • Manage complex and litigated workers' compensation claims from inception through resolution
  • Investigate claims and determine compensability
  • Administer benefits in accordance with California workers' compensation regulations
  • Review and authorize medical treatment and related expenses
  • Establish and maintain claim reserves
  • Negotiate settlements and obtain required approvals
  • Partner with defense attorneys on litigated claims
  • Maintain accurate claim notes, documentation, and diary activities
  • Communicate claim status and recommendations with clients
  • Identify subrogation opportunities and pursue recoveries
  • Assist with audits, regulatory reporting, and compliance requirements
  • Provide guidance and support to junior claims professionals
Qualifications:
  • Minimum of 5 years of Workers' Compensation Claims Examiner experienceSIP experience required
  • Experience handling California workers' compensation claims
  • Strong background managing litigated indemnity claims
  • Experience establishing reserves and negotiating settlements
  • Knowledge of workers' compensation laws, regulations, and medical terminology
  • Strong written, verbal, and client communication skills
  • Ability to manage a caseload independently
Proficiency with Microsoft Word and ExcelAll qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, Los Angeles County Fair Chance Ordinance, and San Francisco Fair Chance Ordinance.
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Level

SeniorL5

Salary

$38.00 - $45.00 per hour

Location

Sacramento, CA

Occupation

Claims Adjusters, Examiners, and Investigators

Industry

Claims Adjusting

Posted

yesterday

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