Workers’ Compensation Senior Claim Representative jobs in United States
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Robert Half · 10 hours ago

Workers’ Compensation Senior Claim Representative

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. They are seeking an experienced Workers Compensation Lost Time Senior Claim Examiner to manage lost time workers compensation claims and deliver high-quality claims service in a fast-paced environment.

ConsultingHuman ResourcesRecruitingSecurity

Responsibilities

Manage all aspects of lost time workers compensation claims from initiation through closure
Conduct three-part investigations, including statements from insureds, claimants, and medical providers
Determine claim compensability based on investigation outcomes
Administer statutory medical and indemnity benefits timely and accurately
Communicate denials and updates to insureds, claimants, attorneys, and involved parties
Set and adjust reserves within authority, escalating when necessary
Collaborate with legal counsel on hearings and litigation matters
Direct vendors and medical case managers on return-to-work strategies
Comply with all state and regulatory reporting requirements
Refer appropriate claims for subrogation and maximize recovery efforts
Partner with internal teams (nurses, investigators, case managers) for optimal claim outcomes
Prepare clear, professional documentation and reports

Qualification

Workers Compensation ClaimsCalifornia Workers Compensation CertificationMicrosoft OfficeElectronic Claim SystemsMedical TerminologyAnalytical SkillsCustomer Service OrientationOrganizational SkillsTime ManagementCommunication Skills

Required

Prior experience handling workers compensation lost time claims required
Certification to manage California Workers Compensation claims required
Strong communication and analytical skills
Proficient in Microsoft Office and electronic claim systems
Familiarity with medical terminology and bill processing
Proven organizational and time management skills
Ability to manage multiple priorities and meet deadlines consistently
Commitment to high-quality work and service standards
Must obtain or maintain applicable state adjuster licenses as required

Preferred

Experience handling claims in CO, UT, NV, and AZ is a plus
Experience in fast-paced, customer-oriented environments
Background in insurance, legal, or corporate business environments
AIC, RMA, or CPCU coursework/designations (preferred but not required)

Benefits

Medical
Vision
Dental
Life and disability insurance
401(k) plan

Company

Robert Half

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Funding

Current Stage
Public Company
Total Funding
unknown
1978-01-13IPO

Leadership Team

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Keith Waddell
President and CEO
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Paul Gentzkow
President and Chief Executive Officer, Talent Solutions
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