California Workers’ Compensation Claims Adjuster

Temporary/Contract | Remote | California

Position Overview

Our client is seeking an experienced Workers’ Compensation Claims Adjuster for a temporary, fully remote assignment. The ideal candidate will have strong California workers’ compensation claims experience and be comfortable independently managing an assigned caseload in a fast-paced environment.

This position will be responsible for investigating, evaluating, and managing workers’ compensation claims while providing excellent communication and customer service to injured workers, employers, medical providers, attorneys, and other stakeholders.

Responsibilities

• Manage an assigned caseload of California workers’ compensation claims from initial assignment through resolution.
• Investigate claims and determine compensability in accordance with California workers’ compensation laws and regulations.
• Review medical records, bills, reports, wage information, and other claim documentation.
• Communicate regularly with injured workers, employers, medical providers, attorneys, and other involved parties.
• Evaluate reserves and claim exposure and make appropriate adjustments as needed.
• Coordinate medical treatment and work closely with medical providers and other claim professionals.
• Review and process indemnity and medical benefits.
• Prepare correspondence, claim notes, reports, and other required documentation.
• Identify potential subrogation, fraud, litigation, and other claim-related issues.
• Work with defense counsel on litigated claims, when applicable.
• Maintain accurate and timely claim files and documentation.
• Ensure claims are handled in compliance with company procedures and applicable California workers’ compensation requirements.
• Meet established productivity, quality, and service-level expectations.
• Participate in team meetings, training, and other activities as required.

Qualifications

• 3+ years of California workers’ compensation claims adjusting experience preferred.
• Strong knowledge of California workers’ compensation laws, regulations, and claims practices.
• Experience handling lost-time and/or indemnity claims strongly preferred.
• Experience managing a full claims caseload from investigation through resolution.
• Strong knowledge of medical terminology, treatment, reserves, benefits, and claims evaluation.

Remote Work Requirements

• Must have a reliable high-speed internet connection.
• Must have a professional, distraction-free home office.
• Ability to work independently and maintain productivity in a fully remote environment.
• Must be available during the client's normal business hours.
• Computer equipment and system access will be provided as determined by the client.

Assignment Details

Position: Workers’ Compensation Claims Adjuster

Location: Remote – California

Employment Type: Temporary/Contract

Duration: [2-3 months / TBD]

Schedule: Monday–Friday, [Hours]

To Apply:

Please submit your resume highlighting your California workers’ compensation claims experience, including the types of claims and caseloads you have managed.

Important California WC Note

California has specific training/designation requirements for workers’ compensation claims adjusters. The California Department of Insurance states that claims adjusters must either meet the applicable experience requirements or complete required training; for a claims adjuster who does not meet the experience requirement, the minimum is 160 hours of training, including 120 hours with an instructor.

California's Division of Workers' Compensation also notes that an experienced WC adjuster can meet the certification standard with five years of California workers’ compensation adjusting or supervisory experience within the last eight years, among other qualifying pathways.