CA Senior Claims Specialist

This is a Fully Remote Job
About Our Client:
The organization operates in the risk management sector, specializing in workers' compensation, auto, health, and disability management solutions. Established in 1987 and publicly traded since 1991, it addresses challenges in managing claims and risk by providing integrated services supported by technology and human capital. The company has a workforce of over 4,000 employees across the United States and emphasizes core values centered on accountability, commitment, excellence, integrity, and teamwork.
About the Opportunity:
The CA SENIOR CLAIMS SPECIALIST role is focused on managing complex and high-profile workers' compensation claims to achieve optimal outcomes. This position collaborates with case managers and attorneys, handles subrogation and settlement negotiations, and ensures claims are resolved efficiently while meeting customer service standards. The role contributes directly to controlling claim costs and supports the overall goals of the claims department.
Responsibilities:
Receive and confirm workers’ compensation claims and policy coverage
Investigate claims to determine validity and compensability
File necessary documentation with state agencies
Establish reserves and authorize payments within limits
Develop and manage action plans to reduce claim costs
Coordinate early return-to-work efforts
Manage subrogation and litigation aspects of claims
Handle potential recoveries related to claims
Report claims to excess carriers when applicable
Communicate claim status with customers and claimants
Adhere to client and carrier guidelines and participate in claim reviews
Maintain professional customer relationships
Comply with applicable state rules and regulations
Follow safety rules as per Injury and Illness Prevention Program
Perform additional duties as assigned
Requirements:
Bachelor’s degree or equivalent combination of education and experience
Minimum of 3 years of industry experience and claim handling
Self-Insured Certificate preferred
State certification or license as an experienced claims adjuster
Current license or certification in workers’ compensation maintained throughout employment
Proficient in Microsoft Office, including Excel
Strong communication, interpersonal, time management, and organizational skills
Ability to work independently and collaboratively
Knowledge of claims administration, case management, and cost containment for workers’ compensation
Pay Range and Compensation Package:
Pay Range: $29.35 - $47.28 per hour
Benefits & Perks:
Medical (HDHP) with pharmacy
Dental insurance
Vision insurance
Long Term Disability insurance
Health Savings Account options
Flexible Spending Account options
Life Insurance
Accident Insurance
Critical Illness Insurance
Pre-paid Legal Insurance
Parking and Transit FSA accounts
401(k) and ROTH 401(k)
Paid time off
Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company's career page or ATS.

Work arrangement
Yes