Complex Claims Adjuster, Workers Compensation (California)

The Complex Claims Adjuster will independently handle all aspects of catastrophic and large loss workers’ compensation claims from set-up to closure. They will conduct timely investigations, determine compensability decisions, and set accurate reserves. This role requires compliance with statutory guidelines, control of legal activity, and prioritization of early resolution opportunities. They will also serve as a point of contact for partner agents and customers, providing guidance and addressing service gaps. This role will also assess claims for settlement value, obtain settlement authority, and attend mediations and trials. They will develop collaborative plans of action, create claims status reports, and present large loss updates. This role requires collaboration with the Complex Claims Practices Consultant and Claims Leadership to improve claims operations.