TEKsystems · 14 hours ago
Workers’ Compensation Senior Claim Representative
Los Angeles, CA
Full-time
Onsite
Senior Level
$46/hr - $48/hrTEKsystems is a leading provider of business and technology services, and they are currently seeking a Workers’ Compensation Senior Claim Representative to handle claims from California. The successful candidate will manage all aspects of workers compensation lost time claims, ensuring effective communication and compliance throughout the process.
Information Technology
Responsibilities
Handles all aspects of workers compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process
Reviews claim and policy information to provide for investigation
Conducts 3-part ongoing investigations obtaining facts and taking statements as necessary with insured claimant and medical providers
Evaluates the facts gathered through the investigation to determine compensability of the claim
Informs insureds claimants and attorneys of claim denials when applicable
Prepares reports on investigation settlements denials of claims and evaluations of involved parties etc
Timely administration of statutory medical and indemnity benefits throughout the life of the claim
Sets reserves within authority limits for medical indemnity and expenses and recommends reserve changes to Team Leader throughout the life of the claim
Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them
Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered
Works with attorneys to manage hearings and litigation
Controls and directs vendors nurse case managers telephonic cases managers and rehabilitation managers on medical management and return to work initiatives
Complies with customer service requests including Special Claims Handling procedures file status notes and claim reviews
Files workers compensation forms and electronic data with states to ensure compliance with statutory regulations
Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized
Works with in-house Technical Assistants Special Investigators Nurse Consultants Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service
Qualification
Required
Experience working in a customer focused fast-paced fluid environment
Experience utilizing strong communication and telephonic skills
Prior experience requiring a high level of organization follow-up and accountability
Prior workers compensation claim handling experience or other similar type of claim handling experience is required healthcare short-term / long-term disability auto personal injury protection / medical injury or general liability
Knowledge of medical terminology is required
Knowledge of bill processing is required
Certification to handle CA Workers Compensation claims is required
Proficiency with Microsoft Office Products
Lost Time Claim Examiner position with prior experience in workers compensation as a lost time examiner
Requires basic knowledge of workers compensation statutes regulations and compliance
Ability to incorporate data analytics and modeling into daily activities to expedite fair and equitable resolution of claims and claim issues
Exceptional customer service and focus
Ability to openly collaborate with leadership and peers to accomplish goals
Demonstrates a commitment to a career in claims
Exceptional time management and multi-tasking capabilities with consistent follow through to meet deadlines
Use analytical skills to find mutually beneficial solutions to claim and customer issues
Ability to prepare and make exceptional presentations to internal and external customers
Conscientious about the quality and professionalism of work product and relationships with co-workers and clients
Willing to take ownership and tackle obstacles to meet Chubb's quality standards for service investigation reserving inventory management teamwork and diversity appreciation
Superior verbal and written communication skills
Preferred
Prior insurance legal or corporate business experience is a plus but not required
AIC RMA or CPCU completed coursework or designations is a plus but not required
Experience handling claims in the states of CO UT NV and AZ preferred
Benefits
Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
Life Insurance (Voluntary Life & AD&D for the employee and dependents)
Short and long-term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, Vacation or Sick Leave)
Company
TEKsystems
At TEKsystems, they understand people. Every year they deploy over 80,000 IT professionals at 6,000 client sites across North America,
Founded in 1994
10001+ employees
H1B Sponsorship
TEKsystems has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (46)
2024 (52)
2023 (33)
2022 (22)
2021 (36)
2020 (53)
Funding
Current Stage
Late StageLeadership Team
Ryan Skains
Vice President, TEKsystems Global Services
Recent News
Morningstar.com
2026-02-03
2025-11-19
2025-10-29
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