Senior Workers' Compensation Claims Adjuster

1 day ago


California, United States ECLARO Full time

We are seeking a Senior Workers' Compensation Claims Adjuster to join our team at ECLARO. The ideal candidate will have a deep understanding of California workers' compensation laws and regulations, including thorough knowledge of the Labor Code, case law, and related statutes.

MUST COME FROM AN INSURANCE INDUSTRY BACKGROUND & not HEALTH INSURANCE

THIS IS A MUST: Experience in Continuous trauma.

Must be certified in CA

Position is Remote

Key Responsibilities:

  • Manage and adjust complex lost time workers' compensation claims from inception to closure, ensuring compliance with state regulations.
  • Conduct thorough investigations, assess liability, and make appropriate claims determinations.
  • Coordinate medical care, rehabilitation, and return-to-work strategies for injured employees.
  • Handle settlement negotiations, including preparing and presenting cases for hearings and trials, if necessary.
  • Work closely with internal legal counsel, claims managers, and third-party administrators (TPAs) to ensure claims are handled efficiently and in line with company policies.

Qualifications:

  • Minimum of five years of experience handling lost time claims in California.
  • Experience in Continuous trauma.
  • Candidates will be working on old claims filling
  • Proven ability to handle complex claims and maintain a high level of accuracy and detail.
  • Strong negotiation skills, with the ability to effectively resolve claims while minimizing costs.
  • Familiarity with California state reporting requirements and the ability to manage claims within legal timelines.
  • Excellent communication skills, both verbal and written, for interacting with claimants, attorneys, and healthcare providers.
  • CA does not have licenses, but person must be certified in CA


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