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Senior Workers' Compensation Claims Examiner

Job Description:

About the Role:

Are you a strategic thinker with a passion for supporting injured workers on their path to recovery? As a Senior Workers' Compensation Claims Examiner, you'll play a pivotal role in administering benefits and ensuring injured employees receive the care they need. Reporting to the Director of Workers' Compensation, you'll expertly navigate California's workers' compensation regulations while providing exceptional service, all within a fast-paced and collaborative environment. This role is perfect for a proactive problem-solver who thrives on making a meaningful difference in the lives of others while balancing risk mitigation with compassionate claims handling.

Requirements:

What You'll Do:

• Drive Smart Claims Decisions: Ensure timely and accurate liability determinations and benefit provisions.
• Be the Key Connector: Establish essential communication between Member County, injured employees, and healthcare providers.
• Champion Recovery: Coordinate early return-to-work efforts that benefit both employees and organizations.
• Own Your Portfolio: Efficiently manage a manageable caseload of claims, finalizing and controlling their resolution.
• Advocate for Proper Care: Authorize medical treatments within pre-established authority levels.
• Ensure Compliance: Investigate, review, and adjust claims in accordance with California Labor Code regulations.
• Optimize Resources: Establish claim reserves, approve payments, and coordinate resolution strategies.
• Guide Stakeholders: Serve as a trusted resource for claims-related questions and guidance.
• Collaborate with Legal Experts: Work alongside defense counsel on litigated claims, ensuring accurate records and strategic case resolutions.
• Stay Ahead of Industry Changes: Keep informed about evolving laws, court rulings, and best practices that impact workers' compensation.
• Maintain Confidentiality: Handle sensitive information with the utmost discretion.

What We're Looking For:

• Knowledge of California Workers' Compensation law, including Section 4850.
• Sharp analytical skills and problem-solving abilities to navigate complex claims.
• Outstanding communication skills--both written and verbal.
• Ethical and professional conduct with a keen attention to detail.
• Proficiency in Microsoft Office Suite and related tools.

Your Background:

• 3-5+ years of experience in occupational claims administration within California.
• California Self-Insurance Plans Administrator (SIP) Certification or ability to pass exam within 6 months.
• WCCA designation preferred.

Perks & Benefits:

• Cal Pers, Dental, Vision, PTO, Paid Holidays and Optional HSA/401 K
• Meaningful work where you make an impact on people's recovery.
• A collaborative team that values expertise and innovation.
• Opportunities to attend industry conferences and professional development trainings.
• The ability to refine best practices and influence claims resolution strategies.

Physical & Travel Requirements:

• Hybrid schedule available
• Ability to lift up to 15 lbs occasionally.
• Some overnight travel for meetings, training, and claims reviews.

Application Procedures:

Applying to Trindel is a straightforward process designed to connect passionate professionals with meaningful opportunities. Start by exploring open positions on our website and submitting an online application with your resume and cover letter. Qualified candidates will be invited to an interview, where we'll discuss your skills, experience, and alignment with our mission. The final selection involves reference checks and potential follow-up interviews. Once an offer is extended, onboarding begins to ensure a smooth transition into our collaborative, impact-driven team.