Workers Compensation Claims Examiner

Acrisure

Workers’ Compensation Claims Examiner managing California-based workers’ compensation claims remotely. Investigating claims and coordinating the claims process in compliance with California regulations.

Posted 5/27/2026full-timeRemote • California • 🇺🇸 United StatesMid-LevelSenior💰 $85,000 - $95,000 per yearWebsite

About the role

Key responsibilities & impact

Manage a caseload of California workers’ compensation claims from initial assignment through final resolution
Review and evaluate coverage, liability, and compensability in accordance with California Labor Code and regulatory requirements
Conduct thorough investigations, including gathering statements, reviewing reports, and analyzing claim documentation
Set and manage reserves based on exposure and claim developments
Ensure timely and accurate benefit payments and required communications
Maintain claim diaries and ensure consistent follow up throughout the life of the claim
Coordinate return to work efforts and monitor ongoing claim activity
Oversee litigation, including working with defense counsel and participating in claim strategy discussions
Negotiate settlements within authority and provide recommendations on cases exceeding authority
Identify potential fraud, subrogation, and cost containment opportunities
Maintain accurate and compliant documentation within the claims system
Communicate effectively with injured workers, employers, medical providers, attorneys, and internal stakeholders

Requirements

What you’ll need

3+ years of experience handling workers’ compensation claims required
An active California Adjuster License, experience working with self-insured claims programs (OSIP or SIP), or a Certified Workers’ Compensation Professional (CWCP) designation
Strong knowledge of California workers’ compensation laws and claims handling practices
Experience managing indemnity claims, litigation, and claim resolution strategies
Strong analytical, decision making, and problem solving skills
Excellent verbal and written communication skills
Strong organizational skills and ability to manage multiple claims
Ability to work independently in a remote environment
Proficiency with Microsoft Office and claims management systems

Benefits

Comp & perks

Comprehensive medical insurance, dental insurance, and vision insurance
Life and disability insurance
Fertility benefits
Wellness resources
Paid sick time
Generous paid time off and holidays
Employee Assistance Program (EAP)
Complimentary Calm app subscription
Immediate vesting in a 401(k) plan
Health Savings Account (HSA) and Flexible Spending Account (FSA) options
Commuter benefits
Employee discount programs
Paid maternity leave and paid paternity leave (including for adoptive parents)
Legal plan options
Pet insurance coverage

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

workers’ compensation claims managementcoverage evaluationliability assessmentcompensability analysisclaims investigationreserve managementsettlement negotiationfraud identificationsubrogationcost containment

Soft Skills

analytical skillsdecision makingproblem solvingverbal communicationwritten communicationorganizational skillsindependent worktime managementstakeholder communicationnegotiation

Certifications

California Adjuster LicenseCertified Workers’ Compensation Professional (CWCP)