Senior Workers Compensation Claims Examiner

Acrisure

Senior Workers' Compensation Claims Examiner managing complex California workers' compensation claims for Acrisure. Investigating, evaluating, and developing resolution strategies while ensuring compliance with California regulations.

Posted 7/6/2026full-timeRemote • California • 🇺🇸 United StatesSenior💰 $95,000 - $110,000 per yearWebsite

About the role

Key responsibilities & impact

Independently manage a caseload of California workers' compensation claims from assignment through resolution
Investigate claims, evaluate compensability, and determine appropriate claim handling strategies
Review coverage, liability, medical documentation, and claim exposure in accordance with California regulations
Establish and manage reserves based on claim exposure and ongoing developments
Manage complex indemnity claims, including litigated files and settlement negotiations
Coordinate with defense counsel, medical providers, employers, and other stakeholders throughout the claims process
Monitor claim progress, maintain accurate diaries, and ensure timely follow-up on all assigned files
Coordinate return-to-work efforts and support positive claim outcomes
Identify fraud, subrogation, and cost containment opportunities when appropriate
Maintain complete, accurate, and timely documentation within the claims management system
Provide guidance and claim recommendations on complex files as needed
Perform additional duties and projects as assigned

Requirements

What you’ll need

5+ years of experience handling California workers' compensation claims required
Experience managing indemnity claims required
Experience handling litigated workers' compensation claims required
Current California Adjuster Certification, OSIP/SIP self-insured qualification, or Certified Workers' Compensation Professional (CWCP) designation required
Strong knowledge of California workers' compensation laws, regulations, and claims handling practices
Experience developing claim resolution strategies and negotiating settlements
Ability to independently manage complex claims with minimal supervision
Strong analytical, decision-making, and problem-solving skills
Excellent verbal and written communication skills
Strong organizational skills with the ability to manage multiple priorities in a remote environment
Proficiency with Microsoft Office and claims management systems

Benefits

Comp & perks

Comprehensive medical insurance
Dental insurance
Vision insurance
Life and disability insurance
Fertility benefits
Wellness resources
Paid sick time
Generous paid time off
EAP
Complimentary Calm app subscription
Immediate vesting in a 401(k) plan
HSA and FSA options
Commuter benefits
Employee discount programs
Paid maternity leave
Paid paternity leave

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Claims InvestigationCompensability EvaluationClaims Handling StrategiesReserve ManagementFraud IdentificationSubrogation OpportunitiesCost ContainmentDocumentation ManagementSettlement NegotiationClaims Analysis

Soft Skills

Analytical SkillsDecision-MakingProblem-SolvingVerbal CommunicationWritten CommunicationOrganizational Skills

Certifications

California Adjuster CertificationOSIP/SIP Self-Insured QualificationCertified Workers' Compensation Professional (CWCP)