Sr. Workers Compensation Claims Representative

Senior Workers' Compensation Claims Representative Job Summary Seeking a highly skilled and experienced Senior Workers' Compensation Claims Representative to join a team. This role involves managing Workers’ Compensation claims from inception to resolution, ensuring compliance with regulatory requirements, and delivering exceptional service to internal and external stakeholders. The position offers the flexibility of a hybrid work schedule (3 days in-office) or fully remote work. If you have a strong background in claims handling and are looking for a role that values work-life balance and professional growth, we encourage you to apply.

Compensation Package

• Salary: $95,000 - $120,000 per year
• Benefits: Competitive benefits package, 401(k), paid time off, professional development opportunities, and more

Responsibilities

• Manage a caseload of 100-125 Workers’ Compensation claims, including lost time/indemnity files, med-pay, and subrogation.
• Conduct thorough investigations, including obtaining statements, records, and other evidentiary materials.
• Evaluate and set accurate reserves to reflect potential exposure.
• Ensure compliance with regulatory and jurisdictional requirements for claims handling.
• Collaborate with defense counsel, independent adjusters, and other third parties to resolve claims effectively.
• Provide detailed documentation and reporting of claims activities.
• Maintain a high level of service to clients, claimants, and other stakeholders.
• Stay updated on industry regulations and best practices.
• Perform other duties as assigned.

Qualifications/Requirements

• Minimum of 5 years of experience handling Workers’ Compensation claims, including:

• Claims investigation (statements, authorizations, expert retention).

• Claims administration (reserving, compliance with laws, handling lost time and litigated claims).

• Litigation management (collaborating with defense counsel and experts).

• Licensed to handle California Workers’ Compensation claims.

• Familiarity with claims in the construction, forestry, logging, or oil and gas industries is a plus.

• Ability to manage claims across multiple states (CA, OR, WA, AZ, ID, NV).

• Strong knowledge of coverage, reserving principles, investigation, and negotiation techniques.

• Excellent judgment, decision-making, and organizational skills.

• Service-oriented mindset with effective communication skills.

• Ability to travel as needed, including potential overnight stays.