Robert Half · 4 days ago
Workers' Compensation Senior Claim Representative
Los Angeles, CA, US
Full-time
Onsite
Senior LevelRobert Half is seeking an experienced Workers Compensation Lost Time Senior Claim Examiner to join their team in the Los Angeles, CA area. This role involves managing a caseload of lost time workers compensation claims, ensuring high-quality claims service in a fast-paced, customer-driven 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
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)
Company
Robert Half
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Founded in 1948
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
unknown1978-01-13IPO
Leadership Team
Keith Waddell
President and CEO
Paul Gentzkow
President and Chief Executive Officer, Talent Solutions
Recent News
EIN Presswire
2025-04-14
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