Claims Examiner - Workers Compensation

Claims Examiner - Workers Compensation

BCForward is currently looking for Claims Examiner - Workers Compensation - Remote in CA

Position Title: Claims Examiner - Workers Compensation

Location: CA - Remote

Duration: 03+ Months
Pay Rate: $50.00/hr on W2.

Position Overview

We are seeking an experienced Workers' Compensation Claims Adjuster to manage and resolve complex California workers' compensation claims. This role involves investigating, analyzing, and settling high-exposure claims, ensuring compliance with statutory regulations, and delivering exceptional client service.

Key Responsibilities

• Investigate, analyze, and adjudicate complex workers' compensation claims in California.
• Develop and execute action plans for timely and cost-effective claim resolution.
• Negotiate claim settlements within designated authority levels.
• Assign and manage reserves, benefits, and claim payments.
• Prepare and submit necessary state filings within statutory time limits.
• Oversee litigation management and coordinate vendor referrals.
• Identify subrogation opportunities and manage recoveries (e.g., SIF, Medicare, Social Security offsets).
• Maintain accurate documentation and coding for all claims.
• Build and maintain professional client and claimant relationships.
• Support organizational quality programs and perform other duties as assigned.

Qualifications

Education & Licensing:

• Bachelor's degree preferred.
• Relevant insurance certifications (e.g., CA SIP) preferred but not required.

Experience:

• Minimum 3 years of California workers' compensation claims experience required.
• 5+ years of overall claims management experience or equivalent education/experience.

Skills:

• In-depth knowledge of CA workers' compensation laws and insurance principles.
• Strong negotiation, analytical, and problem-solving skills.
• Excellent written and verbal communication skills.
• Proficiency with Microsoft Office Suite and claims management software.
• Ability to manage multiple priorities, work independently, and exceed service expectations.

Work Environment & Additional Information

• Remote role; hybrid available for candidates near San Diego or Roseville.
• Must pass a credit security clearance and background check.
• Occasional travel required.
• Physical requirements: keyboarding, vision, hearing, and speaking abilities necessary for role.

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.

Interested candidates please send resume in Word format Please reference job code 243492 when responding to this ad.

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