Workers' Compensation Lost Time Adjuster (California)

Department: Claims Administration & Adjusting

Employment Type: Permanent - Full Time

Location: San Diego, CA

Reporting To: Judith Ko

Compensation: $39.00 - $43.00 / hour

Description

Key Responsibilities

• Manage workers’ compensation lost time and indemnity claims from initial intake through closure
• Conduct and direct investigations to determine AOE/COE, including timely 24-hour three-point contact with injured workers, employers, and medical providers
• Establish initial reserves promptly and maintain accurate reserves based on probable claim outcomes
• Authorize appropriate medical care and ensure timely issuance of indemnity benefits
• Manage all legal aspects of claims, including litigation and settlement negotiations
• Maintain a diary system to ensure timely benefit administration and proactive claim handling
• Determine settlement value and drive claims toward appropriate and timely resolution
• Deliver exceptional customer service to clients, producers, employers, and injured workers through clear and professional written and verbal communication
• Accurately document claim activity and present claim facts to clients, vendors, and management
• Perform additional duties as assigned

Skills, knowledge & expertise

• Bachelor’s degree from a four-year college or university; or one to two years of related experience and/or training; or an equivalent combination of education and experience
• California Workers’ Compensation experience is required
• Multiple years of experience handling Workers’ Compensation claims, including indemnity and litigated claims
• WCCA or WCCP designation
• California Self-Insured Certification
• Proficiency with Microsoft Office Suite and claims management systems 
• Excellent written and verbal communication skills with a strong customer service focus
• Strong investigative, analytical, and claim evaluation skills
• Ability to independently manage a caseload in a fast-paced, deadline-driven environment
• Proven organizational, problem-solving, and decision-making abilities
• Self-starter who can work with minimal direction while meeting or exceeding performance goals
• Ability to adapt and maintain a positive, collaborative work atmosphere amid changing priorities

Benefits

• Medical, dental, and vision plans to ensure your health and that of your family.
• A 401k plan with employer matching to help you build a secure financial future.
• Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
• Paid holidays.
• Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.