Job DescriptionJob SummaryAcrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This role is responsible for investigating claims, determining compensability, managing litigation, evaluating exposure, and developing claim resolution strategies while ensuring compliance with California workers' compensation laws and regulations.
Candidates must have direct, hands-on experience handling California workers' compensation claims. An active California Adjuster Certification, experience handling self-insured claims through the California Office of Self-Insurance Plans (OSIP/SIP), or a Certified Workers' Compensation Professional (CWCP) designation is required.
This is a fully remote position. Candidates must be able to support California-based claims and work business hours aligned with Mountain or Pacific Time zones.
Responsibilities- Independently manage a caseload of California workers' compensation claims from assignment through resolution
- Investigate claims, evaluate compensability, and determine appropriate claim handling strategies
- Review coverage, liability, medical documentation, and claim exposure in accordance with California regulations
- Establish and manage reserves based on claim exposure and ongoing developments
- Manage complex indemnity claims, including litigated files and settlement negotiations
- Coordinate with defense counsel, medical providers, employers, and other stakeholders throughout the claims process
- Monitor claim progress, maintain accurate diaries, and ensure timely follow-up on all assigned files
- Coordinate return-to-work efforts and support positive claim outcomes
- Identify fraud, subrogation, and cost containment opportunities when appropriate
- Maintain complete, accurate, and timely documentation within the claims management system
- Provide guidance and claim recommendations on complex files as needed
- Perform additional duties and projects as assigned
Requirements- 5+ years of experience handling California workers' compensation claims required
- Experience managing indemnity claims required
- Experience handling litigated workers' compensation claims required
- Current California Adjuster Certification, OSIP/SIP self-insured qualification, or Certified Workers' Compensation Professional (CWCP) designation required
- Strong knowledge of California workers' compensation laws, regulations, and claims handling practices
- Experience developing claim resolution strategies and negotiating settlements
- Ability to independently manage complex claims with minimal supervision
- Strong analytical, decision-making, and problem-solving skills
- Excellent verbal and written communication skills
- Strong organizational skills with the ability to manage multiple priorities in a remote environment
- Proficiency with Microsoft Office and claims management systems
EDUCATION AND LICENSES- High school diploma or equivalent required
- Additional education beneficial
- Current California Adjuster Certification, OSIP/SIP self-insured qualification, or Certified Workers' Compensation Professional (CWCP) designation required
Pay Details:
The base compensation range for this position is $95,000 - $110,000. This range reflects Acrisure's good faith estimate at the time of this posting. Placement within the range will be based on a variety of factors, including but not limited to skills, experience, qualifications, location, and internal equity.
Candidates should be comfortable with an on-site presence to support collaboration, team leadership, and cross-functional partnership.Employee BenefitsWe also offer our employees a comprehensive suite of benefits and perks, including:
- Physical Wellness: Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time.
- Mental Wellness: Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription.
- Financial Wellness: Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs.
- Family Care: Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage.
- ... and so much more!
This list is not exhaustive of all available benefits. Eligibility and waiting periods may apply to certain offerings. Benefits may vary based on subsidiary entity and geographic location.
