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Claims Examiner

Location : San Diego, CA
Job Type : Direct
Hours : Full Time
Travel : No
Relocation : No

Job Description :

Claims Adjuster responsibilities include, but are not limited to:

  • Thoroughly investigating workers’ compensation claims by contacting injured workers, medical providers, and employer representatives.

  • Determining if claims are valid under applicable workers’ comp statutes.

  • Communicating with medical providers to develop and authorize appropriate treatment plans.

  • Reviewing and analyzing medical bills to confirm charges and treatment are workers’ comp injury-related and in accordance with the treatment plan.

  • Ensuring payments for medical bills and income replacement are remitted on a timely basis in accordance with applicable fee schedules and statutes.

  • Assisting in estimating appropriate reserves for each claim.

  • Providing information as needed for litigation or settlement negotiations.


Required Qualifications :

The ideal Claims Adjuster will have:


  • At least 3+ years’ experience as a workers’ comp claims adjuster.

  • Strong verbal and written communication skills.

  • Strong organizational skills with attention to details.

  • Ability to work with little supervision.

  • Ability to manage multiple tasks in a fast-paced environment.

  • Proficiency in MS Word, Excel, and Outlook.

We offer the opportunity to join an established company in growth mode. Our benefits package includes medical, dental, vision, disability, and life insurance and 401(k) with employer match. We also offer a business casual work environment and an 8:00-5:00 Monday-Friday work week.

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