Sr Lost Time Adjuster

The Workers’ Compensation Claims Adjuster must be knowledgeable of the California Labor Code and administration of claims. It is the responsibility of a Workers' Compensation Claims Adjuster to receive and organize all documents related to the employee and the injury to make a determination regarding the claim. The Claims Adjuster is responsible for the prompt and efficient examination and investigation of claims.

Workers' Compensation Claims Adjusters abide by company guidelines when making claim determinations. This role requires excellent communication and customer service skills, strong motivation and organizational skills. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud, and claim resolution.
• Complete quality investigations by gathering pertinent information, reviews and evaluates coverage and/or liability, securing necessary information (reports, policies, releases, statements, or other documents) in the investigation of claims.
• Conduct a thorough analysis of liability and continually assess exposure and evaluate for accurate reserves.
• Work toward the resolution of claims files and take full charge of claim from inception to resolution.
• Make settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority.
• Ensure that claims payments are calculated accurately and issued in a timely manner.
• Ensure compliance of claims handling pursuant to all state, legal, statutory, and regulatory requirements and company procedures.
• Maintain a diary to track claim progress on all claims.
• Determine liability for permanent disability, mitigation of costs and resolution of claim.
• Oversee litigation and coordination of claim with defense team.

• 5+ years experience handling workers’ compensation claims.
• Current California Adjuster Certification.
• Familiarity with state workers’ compensation laws and regulations.
• Strong customer service, verbal and written communications, time management, and organizational skills.
• Excellent attention to detail.
• Ability to work independently.
• Strong computer and software skills.

• Manage relationships in a fast‑paced environment with problem solving and decision‑making skills.
• Respond to requests effectively and efficiently.
• Listen effectively and clearly express ideas and recommendations.
• Communicate effectively and clearly, both orally and in writing.
• Capable of carrying out detailed written or verbal instructions.

• Complete understanding of all Microsoft Office applications.
• Apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
• Proficient in operating computer equipment and applications.

• Respond in a timely and consistent manner with all communication.
• Build credibility with internal and external customers.
• Create customer satisfaction.
• Familiar with company tools and comfortable reviewing with all levels of management professionally.

• Uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines.
• Team environment.
• Verbal contact with others.
• Standard work hours:
  Mon‑Fri, 8:30 a‑5 p (37.5 hr per week). Additional hours may be worked based on business needs; adjustment from 8:30‑5 pm per arrangement with management.

• Regularly required to talk or hear; frequently sit; work using a computer; interact with customers (by phone and/or email); use hands to finger, handle or feel; reach with hands and arms.

• Minimal travel primarily local during the business day, with some out‑of‑area and overnight travel possible.

• This job description is not designed to cover a comprehensive listing of all activities, duties or responsibilities that may be required. Duties, responsibilities and activities may change at any time with or without notice.

Candidates should be comfortable with an on‑site presence to support collaboration, team leadership, and cross‑functional partnership.