Workers' Compensation Lost Time Adjuster (California)

DaviesSan Diego, CA
5d$39 - $43Remote

About The Position

Imagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. We’re on the lookout for a Workers’ Compensation Lost Time Adjuster to join our growing team. In this role, you’ll manage a full caseload of workers’ compensation indemnity and lost time claims from inception through resolution. You’ll play a key role in delivering high-quality claims outcomes while maintaining strong communication with injured workers, employers, producers, attorneys, and medical providers. This is a full-time, remote position, with occasional travel required for client claim review meetings.

Requirements

  • Bachelor’s degree from a four-year college or university; or one to two years of related experience and/or training; or an equivalent combination of education and experience
  • California Workers’ Compensation experience is required
  • Multiple years of experience handling Workers’ Compensation claims, including indemnity and litigated claims
  • Proficiency with Microsoft Office Suite and claims management systems
  • Excellent written and verbal communication skills with a strong customer service focus
  • Strong investigative, analytical, and claim evaluation skills
  • Ability to independently manage a caseload in a fast-paced, deadline-driven environment
  • Proven organizational, problem-solving, and decision-making abilities
  • Self-starter who can work with minimal direction while meeting or exceeding performance goals
  • Ability to adapt and maintain a positive, collaborative work atmosphere amid changing priorities

Nice To Haves

  • WCCA or WCCP designation
  • California Self-Insured Certification

Responsibilities

  • Manage workers’ compensation lost time and indemnity claims from initial intake through closure
  • Conduct and direct investigations to determine AOE/COE, including timely 24-hour three-point contact with injured workers, employers, and medical providers
  • Establish initial reserves promptly and maintain accurate reserves based on probable claim outcomes
  • Authorize appropriate medical care and ensure timely issuance of indemnity benefits
  • Manage all legal aspects of claims, including litigation and settlement negotiations
  • Maintain a diary system to ensure timely benefit administration and proactive claim handling
  • Determine settlement value and drive claims toward appropriate and timely resolution
  • Deliver exceptional customer service to clients, producers, employers, and injured workers through clear and professional written and verbal communication
  • Accurately document claim activity and present claim facts to clients, vendors, and management
  • Perform additional duties as assigned

Benefits

  • Medical, dental, and vision plans to ensure your health and that of your family.
  • A 401k plan with employer matching to help you build a secure financial future.
  • Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
  • Paid holidays.
  • Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.
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