CA Senior Claims Specialist

About the role

The organization operates in the risk management sector, specializing in workers' compensation, auto, health, and disability management solutions. Established in 1987 and publicly traded since 1991, it addresses challenges in managing claims and risk by providing integrated services supported by technology and human capital. The company has a workforce of over 4,000 employees across the United States and emphasizes core values centered on accountability, commitment, excellence, integrity, and teamwork.

The CA SENIOR CLAIMS SPECIALIST role is focused on managing complex and high-profile workers' compensation claims to achieve optimal outcomes. This position collaborates with case managers and attorneys, handles subrogation and settlement negotiations, and ensures claims are resolved efficiently while meeting customer service standards. The role contributes directly to controlling claim costs and supports the overall goals of the claims department.

Responsibilities

• Receive and confirm workers’ compensation claims and policy coverage
• Investigate claims to determine validity and compensability
• File necessary documentation with state agencies
• Establish reserves and authorize payments within limits
• Develop and manage action plans to reduce claim costs
• Coordinate early return-to-work efforts
• Manage subrogation and litigation aspects of claims
• Handle potential recoveries related to claims
• Report claims to excess carriers when applicable
• Communicate claim status with customers and claimants
• Adhere to client and carrier guidelines and participate in claim reviews
• Maintain professional customer relationships
• Comply with applicable state rules and regulations
• Follow safety rules as per Injury and Illness Prevention Program
• Perform additional duties as assigned

Requirements

• Bachelor’s degree or equivalent combination of education and experience
• Minimum of 3 years of industry experience and claim handling
• Self-Insured Certificate preferred
• State certification or license as an experienced claims adjuster
• Current license or certification in workers’ compensation maintained throughout employment
• Proficient in Microsoft Office, including Excel
• Strong communication, interpersonal, time management, and organizational skills
• Ability to work independently and collaboratively
• Knowledge of claims administration, case management, and cost containment for workers’ compensation

Pay

Pay Range: $29.35 - $47.28 per hour.

Benefits

• Medical (HDHP) with pharmacy
• Dental insurance
• Vision insurance
• Long Term Disability insurance
• Health Savings Account options
• Flexible Spending Account options
• Life Insurance
• Accident Insurance
• Critical Illness Insurance
• Pre-paid Legal Insurance
• Parking and Transit FSA accounts
• 401(k) and ROTH 401(k)
• Paid time off