Claims Examiner - Workers Compensation

Claims Examiner - Workers Compensation

BC Forward is looking for Claims Examiner - Workers Compensation in Orange, CA 92868

Position Title : Claims Examiner - Workers Compensation

Locations : 333 City Boulevard West, Orange, CA 92868

Anticipated Start Date : 11 / 03

Expected Duration : 2+ Months

Job Type : Contract with possible extension

Pay Rate $47.00 / hr. on W2

Need : Minimum 3-5 years of workers' compensation claims management experience required.

Job Description : Primary Purpose

Responsible for analyzing complex or technically challenging workers' compensation claims to determine benefits due. This includes managing high-exposure cases involving litigation and rehabilitation, ensuring timely and accurate claim adjudication in line with service expectations, industry best practices, and client-specific requirements. The role also involves identifying subrogation opportunities and negotiating settlements.

Essential Responsibilities

• Analyze, investigate, and process complex workers' compensation claims to determine exposure and liability.
• Develop and execute effective action plans to ensure timely claim resolution.
• Negotiate claim settlements within assigned authority limits.
• Establish, review, and maintain adequate reserves throughout the claim lifecycle.
• Calculate and disburse benefits accurately and in compliance with regulations.
• Prepare and file all required state documentation within statutory deadlines.
• Manage the litigation process efficiently, ensuring cost-effective outcomes.
• Coordinate with vendors for investigation, medical management, and litigation support.
• Apply cost-containment strategies and vendor partnerships to reduce claim expenses.
• Manage recoveries such as subrogation, Second Injury Fund, and Social Security / Medicare offsets.
• Communicate claim activity clearly and professionally with clients, claimants, and internal teams.
• Ensure complete and accurate claim documentation and coding.
• Escalate complex cases to supervisors or management as necessary.

Additional Functions

Qualifications

Education & Licensing :

Experience :

Skills & Knowledge :

Work Environment

Mental : Strong analytical thinking, judgment, and problem-solving skills; ability to manage multiple priorities under deadlines.

Physical : Regular computer use; occasional travel required.

Auditory / Visual : Clear communication, hearing, and vision required.

Note : Employment is contingent upon successful completion of a background and credit check.

Manager's Note :

This is a hybrid role based in Orange, CA (2 days onsite weekly). Candidates must have a minimum of 3 years of Workers' Compensation claims examiner experience.

About BCforward

Founded in 1998, BCforward is a Black-owned global leader in workforce management and digital product delivery solutions, headquartered in Indianapolis, IN. With a worldwide team of over 6,000 consultants, BCforward is dedicated to empowering human potential through its core values : People-Centricity, Excellence, and Diversity.

As an industry pioneer, BCforward provides a best-in-class workplace, fostering a culture of accountability, innovation, and optimism. Committed to equal opportunity employment, the company champions diversity and inclusion, striving to create a positive impact for its clients, employees, and communities.

Interested candidates please send resume in Word format Please reference job code 246171 when responding to this ad.

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Job Snapshot

Employee Type Contractor

Location Orange, CA (Onsite)

Job Type Customer Service

Experience Not Specified

Date Posted 10 / 28 / 2025