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Workers Compensation Lost Time Senior Claim Examiner

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:

We are currently seeking an experienced Workers Compensation Lost Time Senior Claim Examiner to join our team in the Los Angeles, CA area. As a Workers Compensation Lost Time Senior Claim Examiner, you will handle a caseload of lost time workers compensation claims originating primarily from California. This Workers Compensation Lost Time Senior Claim Examiner role is an on-site position located in Los Angeles and focuses on delivering high-quality claims service in a fast-paced, customer-driven environment.

Job Responsibility:

  • Manage all aspects of lost time workers compensation claims from initiation through closure
  • Conduct three-part investigations, including statements from insureds, claimants, and medical providers
  • Determine claim compensability based on investigation outcomes
  • Administer statutory medical and indemnity benefits timely and accurately
  • Communicate denials and updates to insureds, claimants, attorneys, and involved parties
  • Set and adjust reserves within authority, escalating when necessary
  • Collaborate with legal counsel on hearings and litigation matters
  • Direct vendors and medical case managers on return-to-work strategies
  • Comply with all state and regulatory reporting requirements
  • Refer appropriate claims for subrogation and maximize recovery efforts
  • Partner with internal teams (nurses, investigators, case managers) for optimal claim outcomes
  • Prepare clear, professional documentation and reports

Requirements:

  • Prior experience handling workers compensation lost time claims required
  • Certification to manage California Workers Compensation claims required
  • Experience handling claims in CO, UT, NV, and AZ is a plus
  • Strong communication and analytical skills
  • Proficient in Microsoft Office and electronic claim systems
  • Familiarity with medical terminology and bill processing
  • Proven organizational and time management skills
  • Ability to manage multiple priorities and meet deadlines consistently
  • Commitment to high-quality work and service standards
  • Must obtain or maintain applicable state adjuster licenses as required

Nice to have:

  • Experience in fast-paced, customer-oriented environments
  • Background in insurance, legal, or corporate business environments
  • AIC, RMA, or CPCU coursework/designations (preferred but not required)
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 01, 2026

Work Type:
On-site work
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