Workers Compensation Bilingual WC Claims Adjuster

Job Description Bilingual Senior Claims Specialist, Workers’ Compensation (California) – Remote/Hybrid | Pasadena, CA

Position Summary
This role manages California Workers’ Compensation claims, overseeing the full claim lifecycle from initial coverage and compensability determinations through investigation, reserving, evaluation, and resolution
. The position ensures timely and effective claim handling in compliance with internal standards and applicable regulatory requirements, while delivering a high level of service to internal and external business partners. The role also offers opportunities to broaden expertise through exposure to additional lines of coverage. This position is eligible for a Remote/Hybrid work schedule.

• Review, set, and evaluate claim reserves to ensure reserves accurately reflect potential exposure

• Investigate claims, which may include meeting with insureds and witnesses, obtaining statements, and securing records and other evidentiary materials

• Provide thorough documentation and reporting of investigation and claims handling activities

• Negotiate claim resolution, including through mediation, arbitration, and other court-supervised settlement efforts; resolve claims with claimants and counsel and prepare appropriate resolution documents

• Maintain a working knowledge of California regulatory and jurisdictional requirements

• Provide direction to and manage defense counsel, independent adjusters, and other third parties retained to assist in claim resolution

• Perform other duties as assigned

Minimum of 5 years of experience with:

• Claims investigation: statements, authorizations, retention of qualified experts and counsel

• Claims administration: reporting; reviewing and setting accurate and timely reserves; compliance knowledge of laws and procedures, including lost time, serious injury, and litigated claims

• Litigation management: partnering with defense counsel and experts to resolve litigated claims

• Knowledge of coverage, reserving principles, investigation methods, and negotiation techniques

Preferred:

• Certified Experienced CA Workers’ Compensation certification

• CA Self-Insured certification

Additional requirements:

• Ability to obtain and maintain state adjusting licenses as needed

• Service-oriented with the ability to provide prompt, efficient, and effective claims and customer service

• Strong written and verbal communication skills with customers, claimants, opposing counsel, defense counsel, and members of the public

• Ability to manage and organize multiple priorities simultaneously

• Excellent judgment, negotiation, and decision-making skills

• Ability to travel, potentially overnight

• Bilingual English/Spanish required (verbal and written)

$90,000 – $120,000
, commensurate with experience.

• Competitive salary and benefits

• Paid vacation plus 12 paid holidays per year

• Health, dental, and vision insurance

• Company-paid life insurance (2x annual earnings)

• 401(k) savings and profit-sharing plan

• Education and training opportunities

• Insurance designations encouraged with financial assistance available

• Daily two-hour flexible start/end time for a 7.5-hour workday

• Employee fitness program

• Pasadena, CA (Remote/Hybrid eligible)