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Claims Examiner- Worker's Compensation (remote in CA only)

Remote, USA Full-time Posted 2026-06-24

Claim Examiner - Workers’ Compensation (remote) Location: Must reside in the state of California... Pay: Depends on experience Duties of the Claim Examiner - Workers’ Compensation: • Receive claim assignments and confirm policy coverages. • Interpret and make decisions using independent judgment on moderate difficulty claims and policy coverages. • Investigate, evaluate, negotiate, and adjudicate first and third-party claims to determine validity and verify the extent of damage. This involves telephone contact with clients, claimants, witnesses, or other relevant parties. • Analyze claims activity and prepare reports for clients, carriers, and management. • Establish reserves, authorize payments within the scope of authority, and settle claims in a cost-effective manner, ensuring timely disbursements. • Make prompt and equitable settlement decisions, issuing company drafts for authorized claims. • Develop subrogation and third-party recovery potential, following reclaim procedures. • Participate in claim reviews. Skills Required for the Claim Examiner - Workers’ Compensation: • Ability to work independently while assimilating various technical subjects. • Strong verbal and written communication skills. • Demonstrated ability to gather and analyze information, determine a course of action, and implement the selected approach. • Proficiency in problem-solving and identifying solutions. • Effective interpersonal skills for dealing with external sources and colleagues at all levels. Education: • Bachelor’s degree or equivalent experience required. • 1-3 years of comprehensive claims investigations/settling experience in Workers’ Compensation or a similar organization Apply Job!

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