CCMSI · 21 hours ago

Remote Workers' Compensation Claims Adjuster – CA Jurisdiction

Las Vegas, NV

Full-time

Remote

Mid, Senior Level

$70K/yr - $95K/yr

5+ years exp

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Responsibilities

Investigate, evaluate, and adjust Workers' Compensation claims in line with California standards and laws.

Determine compensability, calculate wages, and issue timely Temporary Disability (TD) payments.

Manage litigation and communicate effectively with all parties involved.

Establish and maintain reserves within authority levels.

Approve medical, legal, and miscellaneous invoices, negotiating disputes when needed.

Ensure compliance with claims best practices, including timely compensability decisions, diary maintenance, indemnity payments, and medical bill processing.

Negotiate settlements within corporate and client standards, adhering to state laws.

Work with external vendors, including legal and case management services, as appropriate.

Maintain a personal diary for tracking claims and prepare status reports as needed.

Calculate disability rates and coordinate communication with clients and claimants.

Attend hearings, mediations, and legal conferences as required.

Notify excess/reinsurance carriers of qualifying claims.

Perform additional duties as assigned.

Qualification

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Workers' CompensationCA SIP certificateClaims handlingBilingual (Spanish)Microsoft Office