Senior Claims Specialist - Workers' Compensation

Great American Insurance Group•CA Work at Home, OR

2d•$105,000 - $125,000•Remote

About The Position

Strategic Comp is seeking an experienced Senior Claims Specialist to manage California and Oregon workers' compensation claims. This role is responsible for investigating claims, determining compensability, establishing reserves, negotiating settlements, and developing strategies that drive effective claim resolution. We take an extremely aggressive and proactive approach to claims adjusting and are looking for a person who not only knows their jurisdiction’s comp laws but also enjoys the role of putting that experience to good use. Because we focus on outcomes and not just processes, we look for an adjuster who is very skilled at developing strategies to bring claims to resolution. This is a remote position that requires working Pacific Time Zone business hours.

Requirements

Generally, 10+ years of workers' compensation claims adjusting experience, including complex or high-exposure claims.
California experience required; Oregon experience also preferred but not required.
Strong knowledge of California workers' compensation laws, regulations, and claims practices.
Knowledge of Oregon workers' compensation laws and claims practices is a plus.
Ability to work Pacific Time Zone business hours and travel occasionally as needed.
You must be a great communicator, in both written and verbal form, and be able to work with a variety of internal and external contacts.

Nice To Haves

Professional industry designations such as Associate in Claims (AIC) are preferred.

Responsibilities

Manage California and Oregon workers' compensation claims from inception through resolution.
Analyze claim facts and evaluate coverage, compensability, and benefits eligibility.
Develop and execute strategies to achieve timely and favorable claim outcomes.
Establish and maintain appropriate claim reserves.
Negotiate settlements and bring about claim resolution.
Communicate regularly with claimants, insureds, employers, and other stakeholders.
Prepare and present large loss reports to internal and external audiences.
Collaborate with defense counsel on litigation strategy and claim resolution.
Partner with medical case managers, surveillance vendors, and other external resources.
Ensure compliance with Illinois workers' compensation laws and regulations.
Maintain accurate and timely claim documentation.
Analyze claim trends and exposure to support effective decision-making.
Provide exceptional service while building strong relationships with customers and business partners.