Claims Specialist
Pasadena, CA Direct-Hire $70000.00 - $90000.00 Onsite

Job Description

Claims Specialist - Workers' Compensation & Property Casualty

Location: Pasadena, CA
Employment Type: Full-Time
Compensation: Competitive Salary + Performance Bonus Opportunities

Position Summary

A growing risk management and insurance consulting organization is seeking an experienced Claims Specialist to oversee workers' compensation and property & casualty insurance claims while serving as a trusted resource to clients.

This role is responsible for managing open claims, collaborating with insurance adjusters, reducing claim reserves, analyzing claim trends, and presenting recommendations to clients. The ideal candidate will have a strong understanding of claims management processes, workers' compensation regulations, and insurance industry best practices, along with excellent communication and relationship-building skills.

Key Responsibilities

Claims Management

  • Manage workers' compensation and property & casualty insurance claims through resolution.
  • Develop and monitor claim action plans with adjusters and carriers.
  • Follow up with insurance adjusters to ensure timely claim progress and resolution.
  • Identify opportunities to reduce claim costs and reserves.
  • Coordinate and participate in claim review meetings with insurance carriers and stakeholders.

Analysis & Reporting

  • Analyze open claims and identify opportunities for closure and cost savings.
  • Create client-facing reports highlighting claims performance and outcomes.
  • Project experience modifications and prepare statistical reports.
  • Review experience modification calculations and identify discrepancies.
  • Work with regulatory agencies, bureaus, or insurance organizations to correct reporting issues when necessary.

Client Relations & Consulting

  • Present claim reviews and findings to clients.
  • Explain claims activity, trends, reserve changes, and recommendations.
  • Educate clients on claims management strategies and workers' compensation processes.
  • Build and maintain strong relationships with clients, adjusters, and insurance partners.

Compliance & Industry Knowledge

  • Stay current on workers' compensation regulations and insurance industry developments.
  • Apply regulatory knowledge to support effective claims management.
  • Assist clients in understanding relevant laws and claims-related requirements.

Qualifications

Required

  • Several years of workers' compensation, claims management, claims consulting, or insurance claims experience.
  • Strong understanding of workers' compensation claims processes.
  • Knowledge of workers' compensation laws and regulations.
  • Experience working directly with adjusters, carriers, and clients.
  • Excellent verbal and written communication skills.
  • Strong analytical and problem-solving abilities.
  • Ability to effectively present information and recommendations to clients.

Ideal Background

? Workers' Compensation Claims Examiner
? Claims Specialist
? Claims Consultant
? Risk Management Specialist
? Insurance Account Manager
? Workers' Compensation Analyst
? Property & Casualty Claims Professional
? Insurance Claims Adjuster

Benefits

  • Competitive Salary
  • Performance Bonus Opportunities
  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Long-Term Disability Coverage
  • 401(k) with Employer Match
  • Generous PTO
  • Paid Education & Training
  • Strong Career Growth Opportunities
  • Professional Team Environment

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, Los Angeles County Fair Chance Ordinance, and San Francisco Fair Chance Ordinance.

Job Reference: JN -112026-434695