Workers Compensation Claims Examiner | Brea, CA | Sign-On Bonus Eligible
About The Position
The Workers Compensation Claims Examiner analyzes complex or technically difficult workers’ compensation claims to determine benefits due. The role handles high-exposure claims involving litigation and rehabilitation, ensures claims are adjudicated within service expectations, industry best practices, and client requirements, and identifies subrogation opportunities and negotiates settlements. This position is based in Brea, California, with a hybrid schedule requiring two days onsite. The examiner investigates and gathers information to assess claim exposure, develops action plans to resolve claims appropriately and promptly, communicates claim activity to claimants and clients, and reports claims to excess carriers while responding to their requests for direction. California jurisdictional knowledge is required, and a SIP credential must be held or obtained within one year of the start date.
Requirements
- Five years of claims management experience, or an equivalent combination of education and experience.
- High school diploma or GED.
- California jurisdictional knowledge.
- SIP credential required, or must be obtained within one year of the start date.
Nice To Haves
- Bachelor’s degree from an accredited college or university.
- Professional certification applicable to the line of business.
Responsibilities
- Analyze and process claims through well-developed action plans to reach appropriate and timely resolutions.
- Investigate claims and gather information to determine claim exposure.
- Negotiate claim settlements within designated authority.
- Communicate claim activity and processing with claimants and clients.
- Report claims to excess carriers and respond to requests for direction professionally and promptly.
- Identify subrogation opportunities.
Benefits
- Sign-on bonus eligibility.
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- Medical, dental, and vision benefits.
- 401(k) and matching, available on day one.
- Paid time off (PTO).
- Disability and life insurance.
- Employee assistance program.
- Flexible spending account or health savings account.
- Additional voluntary benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
