Claims Examiner/Associate Claims Examiner

Berkley•San Diego, CA

3d•$60,000 - $116,000

About The Position

Preferred Employers Insurance is entering an exciting chapter of growth, and our Claims team will play a pivotal role in shaping our success in the year ahead. We’re looking for passionate professionals to join us in delivering exceptional service and results. Opportunities: Experienced Claims Adjusters & Senior Adjusters – Bring your expertise and make an immediate impact. Associate Claims Examiner (ACE) – Ideal for high-potential individuals with little to no prior claims experience who are eager to learn and grow. If you’re ready to be part of a dynamic team and help shape the future of our organization, we’d love to hear from you! Our Claims team manages workers’ compensation claims with integrity, accuracy, and a commitment to exceptional service. Whether you’re an experienced examiner or just starting your career, you’ll play a key role in ensuring timely and fair resolution of claims in compliance with California WCAB rules and regulations. For Experienced Claims Examiners: Analyze and process workers’ compensation claims, determining coverage, compensability, and exposure. Negotiate settlements within authority limits and manage litigation when necessary. Calculate and assign reserves; ensure reserve adequacy throughout the life of the claim. Prepare state filings and manage vendor referrals for investigations or litigation. Actively pursue recoveries, including subrogation and other offsets. Maintain professional relationships and deliver consistent, high-quality claims service. For Associate Claims Examiners: Participate in comprehensive training on workers’ compensation laws and claims handling. Handle medical-only and minor indemnity claims under supervision. Conduct three-point contact investigations and determine compensability for uncomplicated claims. Develop action plans and manage claims to timely resolution. Provide excellent customer service and complete work queues and diaries promptly.

Requirements

Bachelor’s degree preferred
1–10 years of workers’ compensation claims experience
Professional certification as applicable
Strong negotiation, analytical, and communication skills
Bachelor’s degree preferred
Strong written/verbal communication and organizational skills
Analytical mindset and eagerness to learn
PC literate

Responsibilities

Analyze and process workers’ compensation claims, determining coverage, compensability, and exposure.
Negotiate settlements within authority limits and manage litigation when necessary.
Calculate and assign reserves; ensure reserve adequacy throughout the life of the claim.
Prepare state filings and manage vendor referrals for investigations or litigation.
Actively pursue recoveries, including subrogation and other offsets.
Maintain professional relationships and deliver consistent, high-quality claims service.
Participate in comprehensive training on workers’ compensation laws and claims handling.
Handle medical-only and minor indemnity claims under supervision.
Conduct three-point contact investigations and determine compensability for uncomplicated claims.
Develop action plans and manage claims to timely resolution.
Provide excellent customer service and complete work queues and diaries promptly.