Senior Claims Specialist

BITCO Insurance Companies•Pasadena, CA

7d•$90,000 - $120,000•Hybrid

About The Position

This role manages California Workers’ Compensation claims overseeing the full claim lifecycle from initial coverage and compensability determinations through investigation, reserving, evaluation, and resolution. The position ensures timely and effective claim handling in compliance with company standards and regulatory requirements, while delivering a high level of service to internal and external business partners. The role also offers opportunities to broaden expertise by gaining exposure to additional lines of coverage.

Requirements

Minimum of 5 years of experience with the following:
Claims Investigation – Statements, authorizations, retention of qualified experts and counsel
Claims Administration – Reports, review and set accurate and timely reserves, compliance knowledge of laws and procedures, including lost time, serious injury, and litigated claims
Litigation management – work with defense counsel and experts to resolve litigated claims
Knowledge of coverage, reserving principles, investigation and negotiation techniques
Ability to obtain and maintain state adjusting licenses, as needed
Must be service-oriented, with the ability to provide prompt, efficient, and effective claims and customer service
Ability to communicate clearly and effectively with our customers, claimants, opposing counsel, defense counsel, and members of the public
Ability to manage and organize workload of multiple tasks simultaneously
Excellent judgement, negotiation, and decision making skills
Must be able to travel, potentially overnight
Bilingual in English/Spanish is required (Both verbal and written communications are required)

Nice To Haves

Certified Experienced CA Workers Compensation cert, CA Self-Insured cert. preferred.

Responsibilities

Review and evaluate claim reserves to ensure that the respective reserve properly reflects the potential exposure
Investigate claims, which may include meeting with Insureds and witnesses, and obtaining statements, records, and other evidentiary materials
Provide proper documentation and reporting of investigation and claims handling activities
Negotiates, including through mediation, arbitration, or other court-supervised settlement efforts, settles, and resolves claims with claimants, and their lawyers; provides appropriate claims resolution documents
Maintain a working knowledge of regulatory and jurisdictional requirements
Provides direction to and management of defense counsel, independent adjusters and other third parties retained to assist in a particular claim
Other duties as assigned