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Senior Workers’ Compensation Claim Representative

https://www.roberthalf.com Logo

Robert Half

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Location:
United States , Los Angeles

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Category:

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Contract Type:
Not provided

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Salary:

Not provided

Job Description:

This is an on-site, full-time temporary role. The Senior Workers’ Compensation Claim Representative will be responsible for managing all aspects of lost time claims for California, ensuring superior customer service and compliance with state regulations. As a Senior Workers’ Compensation Claim Representative, you’ll work closely with attorneys, vendors, and internal teams to deliver high-quality claims management services.

Job Responsibility:

  • Manage workers' compensation lost time claims from start to closure
  • Conduct comprehensive investigations and evaluate compensability
  • Communicate claim decisions to insureds, claimants, and attorneys
  • Administer statutory medical and indemnity benefits throughout claim lifecycle
  • Set and adjust reserves within authority limits
  • Collaborate with attorneys on hearings and litigation strategies
  • Direct nurse case managers, rehabilitation vendors, and telephonic case managers
  • Ensure compliance with all statutory filing requirements
  • Pursue subrogation opportunities where applicable
  • Maintain detailed file notes and participate in claim reviews

Requirements:

  • Certification to handle California Workers’ Compensation claims is required
  • Minimum experience in lost time claims handling or similar fields (healthcare, disability, auto injury, etc.)
  • Working knowledge of California workers' compensation statutes and compliance regulations
  • Proficiency in Microsoft Office and familiarity with medical terminology and bill processing
  • Ability to analyze data and incorporate insights into claim resolution
  • Strong written and verbal communication skills
  • Must obtain applicable resident/designated home state adjuster license if not already held

Nice to have:

  • Preferred experience handling claims in CO, UT, NV, and AZ
  • AIC, RMA, or CPCU coursework/designations are a plus
What we offer:
  • medical, vision, dental, and life and disability insurance
  • eligible to enroll in our company 401(k) plan

Additional Information:

Job Posted:
February 20, 2026

Employment Type:
Fulltime
Work Type:
On-site work
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