Senior Workers’ Claims Consultant

Our client is seeking an experienced bilingual Senior Workers' Compensation Claims Examiner to join their California team. The successful candidate will manage moderate to complex workers' compensation claims, ensuring accurate processing and overseeing the benefits for medical care and billing, all while adhering to California state regulations and company policies. This person will have the ability to work remotely.

• Review, investigate, and process workers' compensation claims in accordance with California labor laws and company policies.
• Assess claim eligibility and compensability by gathering and analyzing documentation, including medical records, accident reports, and employment details.
• Communicate with injured employees, healthcare providers, legal representatives, and employers to facilitate effective claim resolutions.
• Identify potential subrogation opportunities and manage settlement negotiations, when applicable.
• Maintain accurate and organized claim files, ensuring compliance with reporting requirements.
• Stay informed about changes in California workers' compensation laws, regulations, and best practices.
• Provide exceptional customer service to injured workers and other stakeholders, addressing inquiries and concerns promptly.

• 5+ years of experience as a Workers' Compensation Claims Examiner, handling California claims.
• Strong knowledge of California workers' compensation laws and regulations.
• SIP Certification preferred.
• Excellent analytical, problem-solving, and organizational skills.
• Exceptional bilingual communication skills, both written and verbal, strongly preferred.

• $95,000 to $120,000 Annual based salary (depending on experience)
• Comprehensive benefits package, including health, dental, and vision insurance
• Employer matching 401k
• Lucrative PTO
• Flexible remote work environment