Senior Workers' Compensation Claims Adjuster (Workers' Compensation)

Location: Rosemead, California, US. Hybrid work mode with required attendance at an SCE facility for a set number of days; employees are generally required to work and reside in California. Up to 5% travel throughout the service territory.

Salary: $114,400–$171,600 per year

Company

Utility company focused on clean energy innovation, emissions reduction, and safe, reliable service.

What you will do

• Manage a complex workers’ compensation claims caseload, including catastrophic claims when assigned.
• Investigate complex claims with managers, medical providers, injured employees, and witnesses to determine liability and coordinate initial medical treatment.
• Administer benefits, control medical costs, coordinate utilization review, and move claims toward resolution.
• Manage complex litigation, direct outside counsel, and represent the employer at Workers’ Compensation Appeals Board proceedings.
• Evaluate claims, establish reserves, negotiate settlements, and structure settlements that may include Medicare Set-Asides.
• Identify and pursue fraud, third-party, and excess insurance recoveries while protecting confidential and sensitive data.

Requirements

• Seven or more years of experience processing workers’ compensation claims and evaluating accident reports for legal and regulatory compliance.
• Seven or more years of experience administering complex, litigated workers’ compensation claims.
• Thorough knowledge of workers’ compensation laws, regulations, disability rates, benefit notices, calculations, awards, commutations, and penalties.
• Experience with permanent disability ratings, AOE/COE investigations, WCAB hearing representation, medical and disability programs, and third-party recovery.
• Strong oral and written communication skills and proficiency with claims management systems.
• Must generally work and reside in California; hybrid facility attendance is required.

Nice to have

• Bachelor’s degree in business or a related technical field, or equivalent Workers’ Compensation education, training, and experience.
• Self-Insured Certificate to adjust or administer workers’ compensation benefits for a self-insured employer.
• California Workers’ Compensation Claim Adjuster Certification.
• Experience with self-administered and self-insured programs.

Culture & Benefits

• Work supporting employee recovery and safe return to work after workplace injuries.
• Hybrid schedule combining work at an SCE facility with remote work on remaining days.
• Up to 5% field travel across the service territory.
• Work connected to clean energy innovation, emissions reduction, and reliable service.
• Reasonable accommodations are available for candidates and employees with disabilities.