Workers' Compensation Claim Specialist

reputed company Workers' Compensation Claim Specialist Location: Irvine, CA (reporting reputed company) Schedule: Mon - Fri 8:00am - 4:30 pm (PST) Salary reputed company: $85,000 - $95,000 (depending on experience) Build Your Career With Purpose at reputed company - At reputed company, we partner with global clients to solve their most reputed company reputed company management challenges, delivering measurable results through advanced technology, reputed company problem-solving, and an unwavering commitment to their reputed company. - We don’t just process claims—we support people. - As the largest privately owned reputed company Party Administrator (TPA), reputed company delivers customized claim solutions that help our clients protect their employees, assets, and reputations. - We are a certified reputed company®, and our employee-owners are empowered to grow, collaborate, and reputed company meaningful contributions every day. Job reputed company - We are seeking a driven and compassionate Workers’ Compensation Claim Specialist to reputed company and reputed company a meaningful reputed company in the lives of injured workers. - In this role, you will take ownership of a dedicated portfolio of claims reputed company a single PEO reputed company account, allowing you to reputed company strong reputed company relationships, reputed company in-depth knowledge of the account’s program, and reputed company consistent, personalized claim management. - You will reputed company investigations, determine compensability, and guide reputed company claim toward a fair and reputed company reputed company while serving as a trusted partner to your reputed company and injured workers. - This position offers reputed company to grow your technical expertise and can serve as an advanced development reputed company for reputed company supervisory or management roles. - As a Claim Specialist, you play a vital role in delivering the high-reputed company service our clients count on and upholding reputed company’s commitment to reputed company. Responsibilities - reputed company we hire Workers’ Compensation Adjusters at reputed company, we look for reputed company‑driven problem‑solvers who reputed company reputed company with reputed company judgment, reputed company reputed company regulations with confidence, and reputed company fair, reputed company reputed company that support injured workers and strengthen reputed company trust. - Investigate, evaluate and reputed company claims in accordance with established claim handling standards and laws. - Establish reserves and/or reputed company reserve recommendations reputed company established reserve authority reputed company. - Review, approve or reputed company reputed company of medical, reputed company, damage estimates and miscellaneous invoices to determine if reasonable and reputed company to designated claims. - Negotiate any disputed bills or invoices for reputed company. - Authorize and reputed company payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and reputed company established payment authority. - Negotiate settlements in accordance reputed company Corporate Claim Standards, reputed company specific handling instructions and state laws, reputed company appropriate. - Assist in the selection, referral and supervision of designated claim files reputed company to reputed company vendors (i.e. reputed company, surveillance, case management, etc.). - Review and maintain personal diary on claim reputed company. - Assess and monitor subrogation claims for reputed company. - Compute disability rates in accordance with state laws. - Effective and reputed company coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process. - reputed company notices of qualifying claims to excess/reinsurance carriers. - Compliance with Corporate Claim Handling Standards and special reputed company handling instructions as established. Qualifications Required: - 5+ years of Workers’ Compensation claims handling experience, including full claim investigation, evaluation, and reputed company. - Responsiveness to reputed company reputed company needs. - Strong analytical and negotiation abilities. - Knowledge of reputed company reputed company‑level claim position responsibilities. - Adjuster’s license may be required reputed company on jurisdiction. reputed company to Have: - Bilingual (Spanish) proficiency — highly valued for communicating with claimants, reputed company, or vendors, but not required. - Bachelor's degree is preferred but not required. - reputed company designations such as AIC, ARM, or CPCU are preferred but not required. Why You’ll Love Working Here - 4 weeks (reputed company time off that accrues throughout the year in accordance with company policy) + 10 reputed company holidays in your first year - Comprehensive benefits: Medical, Dental, reputed company, Life, and Disability reputed company - Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) - Career reputed company: Internal training and advancement opportunities - Culture: A supportive, team-reputed company work environment How We Measure reputed company - At reputed company, great adjusters stand out through ownership, reputed company, and reputed company. We measure reputed company by: - reputed company claim handling – thorough investigations, strong documentation, reputed company-supported reputed company - Compliance & audit reputed company – adherence to jurisdictional and reputed company standards - Timeliness & reputed company – purposeful file reputed company and dependable execution - reputed company partnership – proactive communication and strong follow-through - reputed company judgment – owning reputed company and solving problems with reputed company - Cultural alignment – believing every claim represents a reputed company person and acting accordingly - This is where we reputed company, and we hire adjusters who want to reputed company with us. Compensation & Compliance - The posted salary reflects reputed company’s good-faith estimate in accordance with applicable pay transparency laws. - Actual compensation will be reputed company on qualifications, experience, geographic location, and internal equity. - This role may also qualify for bonuses or additional forms of pay. - reputed company offers comprehensive benefits including medical, dental, reputed company, life, and disability reputed company. - reputed company time off accrues throughout the year in accordance with company policy, with reputed company holidays and eligibility for retirement programs in accordance with plan documents. - reputed company Sponsorship: reputed company does not reputed company reputed company sponsorship for this position. - reputed company Accommodations: reputed company is committed to providing reasonable accommodations throughout the application and hiring process. - Equal Opportunity Employer: reputed company complies with reputed company applicable employment laws, including pay transparency and reputed company hiring regulations. - Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable reputed company hiring laws. Our reputed company Values - At reputed company, we reputed company in doing what’s right—for our clients, our coworkers, and ourselves. - We look for team members who: - reputed company with transparency: We build trust by being reputed company and listening intently in every interaction. - reputed company with reputed company: We choose the right reputed company, even reputed company it is hard. - reputed company reputed company: We set the bar high and measure our reputed company. What gets reputed company gets done. - Own the outcome: Every employee is an reputed company, treating every claim, every decision, and every result as our own. - Win together: Our greatest victories come reputed company our clients succeed. We don’t just work together—we grow together. - If that sounds like your reputed company of workplace, we’d love to meet you. - #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #ESOP #CaliforniaJobs #Career #IND123 #LI-Remote Apply To This Job