Workers' Compensation Senior Claim Representative

2 weeks ago


Los Angeles, California, United States Robert Half Full time

We are currently seeking an experienced
Workers Compensation Lost Time Senior Claim Examiner
to join our team in the Los Angeles, CA area. As a
Workers Compensation Lost Time Senior Claim Examiner
, you will handle a caseload of lost time workers compensation claims originating primarily from California. This
Workers Compensation Lost Time Senior Claim Examiner
role is an on-site position located in Los Angeles and focuses on delivering high-quality claims service in a fast-paced, customer-driven environment.

Responsibilities:

  • Manage all aspects of lost time workers compensation claims from initiation through closure.
  • Conduct three-part investigations, including statements from insureds, claimants, and medical providers.
  • Determine claim compensability based on investigation outcomes.
  • Administer statutory medical and indemnity benefits timely and accurately.
  • Communicate denials and updates to insureds, claimants, attorneys, and involved parties.
  • Set and adjust reserves within authority, escalating when necessary.
  • Collaborate with legal counsel on hearings and litigation matters.
  • Direct vendors and medical case managers on return-to-work strategies.
  • Comply with all state and regulatory reporting requirements.
  • Refer appropriate claims for subrogation and maximize recovery efforts.
  • Partner with internal teams (nurses, investigators, case managers) for optimal claim outcomes.
  • Prepare clear, professional documentation and reports.

Job Requirements:

  • Prior experience handling workers compensation lost time claims required.
  • Certification to manage California Workers Compensation claims required.
  • Experience handling claims in CO, UT, NV, and AZ is a plus.
  • Strong communication and analytical skills.
  • Proficient in Microsoft Office and electronic claim systems.
  • Familiarity with medical terminology and bill processing.
  • Proven organizational and time management skills.
  • Ability to manage multiple priorities and meet deadlines consistently.
  • Commitment to high-quality work and service standards.
  • Must obtain or maintain applicable state adjuster licenses as required.

Preferred Qualifications:

  • Experience in fast-paced, customer-oriented environments.
  • Background in insurance, legal, or corporate business environments.
  • AIC, RMA, or CPCU coursework/designations (preferred but not required).

Robert Half is the world's first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app and get 1-tap apply, notifications of AI-matched jobs, and much more.

Robert Half will consider for employment qualified applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit for more information.

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