Workers Compensation Claims Examiner

Workers' Compensation Claims Examiner

A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services, and more.

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.

Candidates must have direct, hands-on experience managing workers' compensation claims. They must also have either an active California Adjuster License, experience working with self-insured claims programs (OSIP or SIP), or a Certified Workers' Compensation Professional (CWCP) designation.

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

Requirements

• 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

Education and Licenses

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

The base compensation range for this position is $85,000 - $95,000. This range reflects Acrisure's good faith estimate at the time of this posting. Placement within the range will be based on a variety of factors, including but not limited to skills, experience, qualifications, location, and internal equity.

Acrisure is an Equal Opportunity Employer. We consider qualified applicants without regard to race, color, religion, sex, national origin, disability, or protected veteran status. Applicants may request reasonable accommodation by contacting View email address on click.appcast.io.