What are the responsibilities and job description for the Workers' Compensation Claims Examiner position at LANI?
Overview
Review and manage complex workers’ compensation claims to determine benefits owed. Handle claims involving litigation and rehabilitation, ensure claims are processed according to client and industry standards, and identify opportunities for recovery and settlement.
Key Responsibilities
- Investigate and process complex or high-exposure workers’ compensation claims
- Develop and follow action plans to resolve claims efficiently
- Negotiate claim settlements within assigned authority
- Calculate and manage claim reserves throughout the claim lifecycle
- Approve payments, benefits, and claim adjustments
- Prepare and submit required state filings
- Coordinate with attorneys and vendors for litigation or investigations
- Manage claim recoveries, including subrogation, Second Injury Fund, and Medicare/Social Security offsets
- Maintain accurate claim documentation and coding
- Communicate professionally with claimants, clients, and internal teams
- Perform other duties as assigned
Qualifications
- 3 years of workers’ compensation claims experience
- Strong knowledge of California workers’ compensation laws
- Excellent written and verbal communication skills
- Detail-oriented, organized, and able to work independently
- Proficient in Microsoft Office and claims management software
Preferred:
- SIP Certification
- Experience with school district claims
- Bachelor’s degree or relevant professional certifications
Fully remote within California
No travel required
How to Apply
Submit your resume directly via really. Qualified candidates will be contacted by the recruiting team.
Pay: $47.00 - $50.00 per hour
Benefits:
- Health insurance
Application Question(s):
- Do you have a Special Investigations Program (SIP) or similar claims investigation certification?
Experience:
- managing workers' compensation claims: 3 years (Required)
Work Location: Remote
Salary : $47 - $50