Workers Compensation Claims Management Advocate

ESM INSITE

Advocate assisting employers with Workers’ Compensation claims and engaging claims examiners for optimal results. Involves analysis, strategy negotiation, and creating professional deliverables.

Posted 7/2/2026full-timeRemote • California • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Assisting and educating employers with managing their Workers’ Compensation claims
Engage with claims examiners to ensure best practices for optimal results
Analyzing loss runs and claim handler status reports
Strategizing and negotiating to move cases to resolution
Documenting results, trends and outcomes
Creating professional deliverables via Salesforce
Analysis of Experience Rating Forms
Calculating X-Mod forecasts
Knowledge of the basis for WCIRB recalculation opportunities
Daily interaction with multiple employers, claim examiners and insurance brokers
Strict organizational ability to set and adhere to tight diaries
Consistent follow up and report scheduling
Leading and facilitating in-person or telephonic claims reviews
Interpreting and summarizing data for employers

Requirements

What you’ll need

3+ years of Workers’ Compensation claims advocacy experience
Certificates of WCCA, WCCP, ARM, Self-Insurance certificate, CPDM or other certification
Prior carrier/TPA claim examiner position
Knowledge of public school districts is key to this open position
Must be a critical thinker and a problem solver
Excellent organizational and time management skills
Must be able to set priorities and manage their time and budgets accordingly
Excellent analytical ability and review of complex claims is required
Excellent computer skills (MSFT Word, Excel, Power Point, Outlook, Teams) is a requirement
Must be able to clearly communicate verbally and in writing and have an ability to summarize data in a succinct manner
Must be able to confidently recommend, persuade, negotiate, and achieve results
A desire to help our company succeed by making a positive contribution to employers and the communities that we serve
Occasional travel to client is required.
Confidentiality is a must.

Benefits

Comp & perks

Competitive salary
Comprehensive Benefits
401K Match
Stock Options
Work From Home

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Claims AnalysisNegotiationData InterpretationX-Mod ForecastingExperience Rating Forms Analysis

Soft Skills

Critical ThinkingProblem SolvingTime ManagementCommunication SkillsFollow-Up

Certifications

WCCAWCCPARMSelf-Insurance CertificateCPDM