[Hiring] Workers Compensation Claims Examiner @Acrisure

Role Description

Acrisure is seeking a Workers’ Compensation Claims Examiner to manage California-based workers’ compensation claims from assignment through resolution. This role is responsible for investigating claims, determining compensability, managing reserves, and coordinating all aspects of the claims process in compliance with California regulations.

This is a fully remote position; however, candidates must be able to support California-based claims and work hours that may be more aligned with Mountain or Pacific Time business operations.

Responsibilities

• Manage a caseload of California workers’ compensation claims from initial assignment through final resolution
• Review and evaluate coverage, liability, and compensability in accordance with California Labor Code and regulatory requirements
• Conduct thorough investigations, including gathering statements, reviewing reports, and analyzing claim documentation
• Set and manage reserves based on exposure and claim developments
• Ensure timely and accurate benefit payments and required communications
• Maintain claim diaries and ensure consistent follow up throughout the life of the claim
• Coordinate return to work efforts and monitor ongoing claim activity
• Oversee litigation, including working with defense counsel and participating in claim strategy discussions
• Negotiate settlements within authority and provide recommendations on cases exceeding authority
• Identify potential fraud, subrogation, and cost containment opportunities
• Maintain accurate and compliant documentation within the claims system
• Communicate effectively with injured workers, employers, medical providers, attorneys, and internal stakeholders

Qualifications

• 3+ years of experience handling workers’ compensation claims required
• An active California Adjuster License, experience working with self-insured claims programs (OSIP or SIP), or a Certified Workers’ Compensation Professional (CWCP) designation
• Strong knowledge of California workers’ compensation laws and claims handling practices
• Experience managing indemnity claims, litigation, and claim resolution strategies
• Strong analytical, decision making, and problem solving skills
• Excellent verbal and written communication skills
• Strong organizational skills and ability to manage multiple claims
• Ability to work independently in a remote environment
• Proficiency with Microsoft Office and claims management systems

Requirements

• Current California Adjuster Certification required OR OSIP/SIP Self-Insured qualification OR Certified Workers’ Compensation Professional (CWCP) designation required
• Additional education beneficial

Benefits

• Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time
• Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription
• Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs
• Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage
• This list is not exhaustive of all available benefits. Eligibility and waiting periods may apply to certain offerings. Benefits may vary based on subsidiary entity and geographic location