Senior California Workers Compensation Adjuster

• Independently manage moderate to complex, high-value casualty claims
• Lead investigations, assess coverage, and issue reservation of rights and coverage letters
• Escalate issues and proactively resolve disputes
• Identify risk transfer and subrogation opportunities
• Negotiate strategically and manage litigation
• Ensure claims activities comply with regulatory and company standards
• Maintain detailed records and prepare comprehensive reports
• Execute jurisdictional compliance requirements
• Set reserves, authorize payments, and make financial decisions within authority
• Coordinate with legal, underwriting, vendors, agents, and other stakeholders
• Lead cross-functional meetings and communicate complex information clearly
• Use advanced tools and analytics to identify trends and improve claims-handling efficiency
• Ensure proper data ingestion, labeling, and protection of personally identifiable information
• Mentor junior claim handlers and support training and best-practice development
• Represent the company in forums related to claims litigation

• Bachelor’s degree preferred, or a combination of education and equivalent experience
• Typically requires 5–10 years of claims handling experience
• Must possess or obtain and maintain appropriate state adjuster licenses and continuing education credits
• Skilled in negotiating complex claims and developing strategies to influence outcomes
• Sound judgment and decision-making on high-exposure cases, including litigation and compliance matters
• Clear and effective verbal and written communication
• Strong organization, time management, and desk management skills
• In-depth understanding of the regulatory environment and jurisdictional requirements
• Exceptional, empathetic customer service skills
• Ability to use a personal computer and standard office equipment
• Ability to sit and/or stand for extended periods
• Required to work on-site as needed
• Ability to travel as necessary
• Ability to work in a fast-paced, changing, or stressful environment
• Ability to work in a noisy/loud work environment

Demonstrates expertise in managing high-value casualty claims, including negotiation, compliance with regulatory standards, and strategic decision-making. Proficient in leading investigations, mentoring junior staff, and utilizing advanced analytics to enhance claims efficiency.

• Claims Handling Experience
• State Adjuster License
• Negotiation Skills
• Regulatory Compliance Knowledge
• Customer Service Skills

• Claims Management
• Risk Transfer Identification
• Subrogation Opportunities
• Litigation Management
• Financial Decision-Making
• Data Protection
• Report Preparation
• Trend Analysis
• Jurisdictional Compliance
• Reservation of Rights Letters

• Effective Communication
• Time Management
• Organization Skills
• Empathy
• Problem-Solving

• State Adjuster License
• Continuing Education Credits

• Casualty Claims
• Claims Litigation
• Coverage Assessment
• High-Exposure Cases
• Claims Activities Compliance

• Advanced Analytics Tools
• Personal Computer
• Standard Office Equipment