Claims Adjuster - Workers Compensation

BCForward is looking for Workers' Compensation Indemnity Claims Examiner- Remote- CA

Job Title: Workers' Compensation Indemnity Claims Examiner

Location: Remote (Must reside in California)

Position Type: Full-Time
Duration: 03+ Months Contract
Pay Rate: $46.42/hr on W2

Position Summary:

We are seeking a skilled Workers' Compensation Indemnity Claims Examiner to join our team. The ideal candidate will have a minimum of 3+ years of experience managing California indemnity claims, with a solid understanding of workers' compensation processes, laws, and best practices. This role is remote within California, and prior public entity experience is preferred though not required. SIP certification is a plus.

Primary Responsibilities:

• Independently manage mid- to high-level California workers' compensation indemnity claims from inception to resolution.
• Determine claim compensability, assess benefits due, and monitor and adjust reserves as needed.
• Develop and execute action plans for resolution, including coordination of return-to-work efforts and approval of claim payments.
• Handle complex lifetime medical and/or defined period medical claims including utilization reviews and treatment authorizations.
• Ensure compliance with state regulations and company standards, including timely filings with the appropriate agencies.
• Actively pursue subrogation opportunities and participate in negotiations and settlement processes.
• Maintain accurate and up-to-date claim documentation and coding.
• Communicate effectively with claimants, clients, medical providers, attorneys, and internal stakeholders.
• Foster and maintain professional client relationships and provide a high level of customer service.
• Travel as required (minimal and project-specific).

Qualifications:

Education & Licensing:

• Bachelor's degree preferred.
• SIP (Self-Insurance Plans) certification is a plus.

Experience:

• Minimum of 3+ years of experience handling California indemnity workers' compensation claims.
• Experience with public entity claims is preferred, but not required.

Skills & Knowledge:

• In-depth knowledge of California workers' compensation laws, benefits structure, medical treatment guidelines, and return-to-work policies.
• Familiarity with state filings, offsets, deductions, and Medicare/Social Security coordination.
• Strong analytical, negotiation, and problem-solving skills.
• Excellent communication (verbal and written) and interpersonal skills.
• High level of organization and attention to detail.
• Comfortable using Microsoft Office Suite and claims management software.

Benefits:

BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

About BCforward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format Please reference job code 239491 when responding to this ad.