Summary:

We are seeking a Workers' Compensation Claims Examiner with a minimum of 3 years of California WC claims experience. This role focuses on managing complex indemnity claims, particularly for public entity clients, and requires deep expertise in California workers' compensation laws, litigation, and settlement processes.

Key Responsibilities:

• Analyze and adjudicate complex and high-exposure workers' compensation claims in compliance with California regulations and client service standards
• Develop and execute strategic claim management action plans
• Calculate, assign, and manage appropriate reserves
• Approve and process timely claim payments and settlements within designated authority
• Prepare and submit required state filings within statutory deadlines
• Oversee litigation, including vendor coordination and legal strategy execution
• Identify and pursue subrogation and other recovery opportunities
• Communicate effectively with claimants, clients, and internal stakeholders
• Maintain accurate and compliant claim documentation and coding
• Ensure ongoing quality and compliance with internal processes and external regulations
  
  

Qualifications:

• Minimum of 3 years of California WC claims experience (required)
• Experience handling public entity and indemnity claims (required)
• OSIP certification (required)
• Bachelor's degree preferred; equivalent experience accepted
• 5+ years of total claims management experience strongly preferred
  
  

Skills and Competencies:

• Expert knowledge of California workers' compensation laws and practices
• Strong negotiation, analytical, and problem-solving skills
• Excellent written and verbal communication
• Proficiency in Microsoft Office and claims management systems
• Ability to handle high caseloads while maintaining accuracy and compliance
• Professionalism, discretion, and client relationship management
• Ability to travel as required
  
  

Work Environment:

Primarily office-based or remote, with occasional travel. Must be able to manage multiple priorities in a fast-paced setting and meet all compliance and deadline requirements.

Nesco Resource offers a comprehensive benefits package for our associates, which includes a MEC (Minimum Essential Coverage) plan that encompasses Medical, Vision, Dental, 401K, and EAP (Employee Assistance Program) services.

Nesco Resource provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.