Senior Claims Adjuster (Workers Compensation)

Location: San Diego, California, United States. Hybrid workplace with a work-from-home program of up to two days per week.

Salary: $84,820–$116,370 per year for this California position.

Company

hirify.global' Workers Compensation Division handles workers compensation insurance claims in Southern California.

What you will do

• Manage a complex caseload of workers compensation indemnity claims from inception through resolution.
• Support medical recovery and early, safe return to work while communicating effectively with injured workers and employers.
• Make compensability determinations, authorize benefits, maintain reserves, and prepare settlement recommendations.
• Negotiate settlements, manage defense attorneys and litigation, and prepare for hearings.
• Coordinate Medical Management, SIU, Subrogation, Recovery, Legal, vendors, and other service partners.
• Manage fraud identification, vocational rehabilitation plans, Medicare Set Asides, Structured Settlements, Part B issues, benefits, notices, and filings.

Requirements

• Minimum eight years of indemnity adjusting experience managing large or complex claims and accounts within a workers compensation carrier.
• High school diploma or equivalent certificate required; a bachelor's degree is preferred.
• California Claims Adjuster or Experienced Claims Adjuster designation and required continuing education credits for adjusting workers compensation claims in California.
• Self-Insured certification is preferred.
• Critical thinking, inquisitiveness, adaptability, and effective time management.
• Proficiency in Microsoft Office and applicable databases, systems, and vendor software.

Nice to have

• Bachelor's degree from a four-year college or university.
• Self-Insured certification.

Culture & Benefits

• Work-life balance and up to two work-from-home days per week.
• Reasonable caseload with in-house Medical Management and Claims Assistant support.
• Paid time off, paid holidays, retirement savings match, and group health insurance.
• Life, AD&D, long-term disability, accident, and critical illness insurance.
• Flexible savings accounts, tuition reimbursement, employee assistance, and a paid community volunteer day.
• Free on-site fitness facility and garage parking, plus diversity, equity, and inclusion initiatives.