Workers Compensation Claims Specialist

Description

Essential Duties & Responsibilities

Performs a combination of duties in accordance with departmental guidelines:

Interprets more complex or unusual policy coverages and determines if coverages apply to claims submitted, escalating issues as needed.

Sets activities, reserves and authorizes payments within scope of authority. Ensures issuance of disbursements while managing loss costs and expenses.

Coordinates and performs investigations and evaluates claims and suits through contact with insureds, claimants, business partners, witnesses and experts. Seeks early resolution opportunities. Identifies files that have potential fraud and refers to SIU.

Utilizes negotiation skills to develop complex settlement packages.

Identifies claims with third party recovery potential and coordinates with subrogation/salvage unit.

Partners with attorneys, account representatives, agents, underwriters, doctors, nurse case managers and insureds to develop a focused strategy for timely and cost effective resolution of more complex claims.

Analyzes claims activities. Prepares and presents reports for management. May be responsible for special projects and presentations.

Responsible for input of data that accurately reflects claim circumstances and other information important to our business outcomes.

May provide guidance and assistance to other claims staff and functional areas.

Keeps current on state/territory regulations and issues as well as industry activity and trends.

May perform additional duties as assigned.

Skills

workers compensation claims, workers compensation, insurance claim

Top Skills Details

workers compensation claims,workers compensation,insurance claim

Additional Skills & Qualifications

Education & Experience

Bachelor's degree or equivalent experience. Professional designations preferred.

Typically a minimum three to five years claims experience.

CA Certifcation required

Skills, Knowledge & Abilities

Solid knowledge of claims and insurance industry theory and practices.

2. Demonstrated technical expertise and product specific knowledge.

3. Strong interpersonal, communication and negotiation skills. Ability to effectively interact with all levels of internal and external business partners.

4. Ability to work independently, managing time and resources to accomplish multiple tasks and meet deadlines.

5. Strong analytical and problem solving skills enabling viable alternative solutions.

6. Ability to exercise independent judgement and make critical business decisions effectively assessing the merits of claims as well as evaluating claims based on a cost benefit analysis.

7. Solid knowledge of Microsoft Office Suite as well as other business-related software.

8. Ability to adapt to change and value diverse opinions and ideas.

9. Ability to fully comprehend claim information; and to further articulate analyses of claims in internal reports.

10. Ability to handle claims with a proactive long-term view of business goals and objectives.

Job Type & Location

This is a Contract to Hire position based out of Brea, CA.

The pay range for this position is $60.00 - $80.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

This is a hybrid position in Brea,CA.

This position is anticipated to close on Aug 28, 2026.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.