Sr. Workers' Compensation Adjuster - California I Remote Opportunity

Overview

Join to apply for the Sr. Workers' Compensation Adjuster - California I Remote Opportunity role at The Mutual Group

This is a remote position requiring minimal supervision. The Senior Workers' Compensation Adjuster is responsible for managing moderate to complex workers' compensation claims from initial investigation through resolution. The ideal candidate will be well-versed in standard claims practices and procedures, and will rely on professional judgment and experience to achieve objectives. The role demands versatility, problem-solving skills, and a degree of creativity. Additionally, the adjuster may provide mentorship or support to junior team members in their claims handling.

Responsibilities

• Investigate coverage, determine compensability, initiate and control delivery of accurate and timely workers' compensation benefits, monitor medical management, and determine accurate and adequate reserves on assigned claims.
• Provide accurate assessments and negotiate fair and efficient claim resolutions while managing costs. Settle losses according to the documented damage, policy language, regulatory and statutory considerations, and within granted authority.
• Prepare written communications, including settlement letters, disclaimers of coverage, and reservation of rights letters.
• Maintain effective claim file documentation and diary system; monitor diary to ensure timely development and disposition of the claim.
• Recognize and pursue recovery opportunities and prepare submissions to SIU when indicated.
• Assign and supervise vendor resources, including independent adjusters, engineers, and other experts as needed.
• Any additional duties as defined.

Requirements / Qualifications

Compensation

Benefits

TMG

Location : Folsom, CA — Remote opportunity

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