Sr Adjuster WC - CA.

TekWissen•Roseville, CA

4d•Onsite

About The Position

The Senior Workers Compensation Adjuster manages moderate to complex and high-value casualty claims with minimal supervision. The role requires advanced investigative and negotiation skills to resolve disputes and escalated situations. The adjuster works with internal and external experts, including legal counsel and technical specialists, to evaluate and resolve claims thoroughly. Responsibilities also include representing the company in claim-related forums, maintaining professionalism, and ensuring compliance with regulatory and company standards. The role calls for strategic thinking, sound judgment, and the ability to handle sensitive, high-impact claim scenarios. The position is an onsite, three-month temporary assignment in Roseville, California. The adjuster may need to travel as necessary and may be required to maintain sufficient home-based internet connection.

Requirements

Five to ten or more years of workers compensation claims-handling experience with an insurance carrier.
Must possess or obtain and maintain appropriate state adjuster licenses and continuing education credits.
Skilled in negotiating complex claims and developing strategies to influence outcomes.
Sound judgment and decision-making on high-exposure cases, including litigation and compliance matters.
Clear and effective verbal and written communication across a variety of situations.
Ability to select appropriate communication channels and demonstrate empathy toward stakeholders.
Strong organization and ability to manage complex workflows and participate in project work.
Strong time-management and desk-management skills, with the ability to mentor others in these areas.
In-depth understanding of the regulatory environment and jurisdictional requirements.
Ability to handle complex compliance issues and mentor others on regulatory standards.
Ability to provide empathetic customer service and manage escalated claims and sensitive customer concerns professionally and clearly.
Ability to use a personal computer and standard office equipment.
Ability to sit and/or stand for extended periods.
Ability to work onsite as needed and travel as necessary.
Ability to work in a fast-paced, changing, or stressful environment and in a noisy or loud work environment.
May be required to have and maintain sufficient home-based internet connection.

Nice To Haves

Bachelor’s degree preferred, or a combination of education and equivalent experience.

Responsibilities

Independently manage moderate to complex, high-value casualty claims, ensuring thorough analysis and resolution.
Lead investigations, assess coverage, issue reservation-of-rights and coverage letters, and escalate issues as needed.
Identify opportunities to transfer risk and pursue subrogation.
Proactively resolve disputes, de-escalate sensitive situations, and pursue optimal outcomes through strategic negotiation and litigation management.
Ensure claims activities comply with regulatory and company standards.
Maintain accurate, detailed records and prepare comprehensive reports.
Execute jurisdictional compliance requirements and support others in understanding regulatory obligations.
Set reserves, authorize payments, and make financial decisions within authority.
Contribute to reserving accuracy and efficiency through sound financial judgment.
Coordinate with legal, underwriting, vendors, agents, and other internal and external stakeholders.
Lead cross-functional meetings and clearly communicate complex information to diverse audiences.
Use advanced tools and analytics to identify trends, correct inconsistencies, and improve claims-handling efficiency.
Ensure proper data ingestion, labeling, and protection of personally identifiable information.
Mentor junior claim handlers on complex claims, compliance, and litigation processes.
Support training initiatives and contribute to best practices and educational materials.