Senior Workers Compensation Claims Adjuster

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🔥 7 minutes ago

🏄 California – Remote

🏄 California – Remote

⏰ Full Time

🟠 Senior

📋 Claims Specialist

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Dayforce

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

👥 HR Tech

☁️ SaaS

🤝 B2B

💰 $1G Post-IPO Debt - Dayforce on 2024-03

HR Tech • SaaS • B2B

Dayforce is a cloud-based human capital management (HCM) platform from Ceridian that delivers payroll, HR, workforce management, talent management, benefits administration, time & attendance, and scheduling capabilities. It is offered as a SaaS solution for employers to manage payroll, compliance, recruiting, performance, and workforce processes in a single platform.

📋 Description

• Independently manage moderate to complex, high-value casualty claims, ensuring thorough analysis and resolution. • Lead thorough investigations, assess coverage, and issue appropriate documentation including reservation of rights and coverage letters. • Escalate issues as needed. • Identify opportunities to transfer risk and pursue subrogation. • Proactively resolve disputes, deescalate sensitive situations, and ensure optimal claim outcomes through strategic negotiation and litigation management. • Ensure all claims activities comply with regulatory and company standards. • Maintain accurate, detailed records and prepare comprehensive reports. • Execute jurisdictional compliance requirements and support others in understanding regulatory obligations. • Set reserves, authorize payments, and make financial decisions within authority. • Demonstrate strong financial acumen and contribute to reserving accuracy and efficiency. • Coordinate with internal and external stakeholders including legal, underwriting, vendors, and agents. • Use advanced tools and analytics to identify trends, correct inconsistencies, and improve claims handling efficiency. • Serve as a mentor to junior claim handlers, providing guidance on complex claims, compliance, and litigation processes. • Deliver empathetic, clear communication throughout the claims process.

🎯 Requirements

• Bachelor’s degree preferred, or a combination of education and equivalent experience. • Typically requires 5–10 years of claims handling experience. • Skilled in negotiating complex claims and developing strategies to influence outcomes. • Communicates clearly and effectively in both verbal and written formats across a variety of situations. • Maintains comprehensive and organized claim records and prepares detailed reports summarizing findings and recommendations. • Highly organized with the ability to manage complex workflows and participate in project work. • Demonstrates strong time management and desk management skills, and mentors others in these areas. • Makes informed decisions based on thorough analysis of complex issues. • Evaluates risks and outcomes, acts independently within authority, and identifies patterns in claims to support resolution strategies. • Highly skilled in investigating complex cases and collaborating with internal and external experts. • Possesses in-depth understanding of the regulatory environment and jurisdictional requirements. • Provides exceptional, empathetic customer service.

🏖️ Benefits

• Must possess or obtain and maintain appropriate state adjuster licenses and continuing education credits. • Attend industry events and continuing education seminars to stay current with best practices, legal developments, and emerging trends.