The Mutual Group
Sr. Workers' Compensation Adjuster - California I Remote Opportunity
The Mutual Group, Sacramento, California, United States, 95828
Overview
Join to apply for the
Sr. Workers' Compensation Adjuster - California I Remote Opportunity
role at
The Mutual Group . This is a remote position requiring minimal supervision. The Senior Workers’ Compensation Adjuster is responsible for managing moderate to complex workers’ compensation claims from initial investigation through resolution. The ideal candidate will be well-versed in standard claims practices and procedures, and will rely on professional judgment and experience to achieve objectives. The role demands versatility, problem-solving skills, and a degree of creativity. Additionally, the adjuster may provide mentorship or support to junior team members in their claims handling.
Responsibilities
Investigate coverage, determine compensability, initiate and control delivery of accurate and timely workers' compensation benefits, monitor medical management, and determine accurate and adequate reserves on assigned claims.
Provide accurate assessments and negotiate fair and efficient claim resolutions while managing costs. Settle losses according to the documented damage, policy language, regulatory and statutory considerations, and within granted authority.
Prepare written communications, including settlement letters, disclaimers of coverage, and reservation of rights letters.
Maintain effective claim file documentation and diary system; monitor diary to ensure timely development and disposition of the claim.
Recognize and pursue recovery opportunities and prepare submissions to SIU when indicated.
Assign and supervise vendor resources, including independent adjusters, engineers, and other experts as needed.
Any additional duties as defined.
Requirements / Qualifications
Bachelor's degree preferred
5-8 years in the handling of Workers’ Compensation Claims
Knowledge of Workers’ Compensation Law
Multi-line claim handling experience beneficial
Ability to work independently in a home-based environment
Strong communication and analytical skills
Ability to negotiate skillfully in difficult situations
Strong organizational and time management skills
Ability to formulate sound expense, indemnity, and loss evaluations and present them effectively
State licensing or certification where required
Basic computer skills including Microsoft Word, Excel, Outlook, and Internet
Ability to perform work-related mathematical problems and calculations
Clear and concise written communication; proper English grammar, punctuation, and spelling
Ability to use commonly used claims concepts, practices, and procedures
Effective verbal and written communication skills
Complete formal training plan and assignments as required
Commitment to nondiscriminatory, lawful, and ethical conduct
Adherence to safe work practices
Compensation
$68,700 - $100,000 commensurate with experience, plus bonus eligibility
$75,600 - $115,000 commensurate with experience in CA, CT, MA, NJ, NY, and PA, plus bonus eligibility
Benefits
Competitive base salary plus incentive plans for eligible team members
401(k) retirement plan with company match up to 6%
Free basic life and AD&D, long-term disability and short-term disability insurance
Medical, dental and vision plans
Wellness incentives
Generous time off, including personal, holiday and volunteer PTO
Flexible work schedules and hybrid/remote options for eligible positions
Educational assistance
#TMG
Location: Folsom, CA — Remote opportunity
#J-18808-Ljbffr
Join to apply for the
Sr. Workers' Compensation Adjuster - California I Remote Opportunity
role at
The Mutual Group . This is a remote position requiring minimal supervision. The Senior Workers’ Compensation Adjuster is responsible for managing moderate to complex workers’ compensation claims from initial investigation through resolution. The ideal candidate will be well-versed in standard claims practices and procedures, and will rely on professional judgment and experience to achieve objectives. The role demands versatility, problem-solving skills, and a degree of creativity. Additionally, the adjuster may provide mentorship or support to junior team members in their claims handling.
Responsibilities
Investigate coverage, determine compensability, initiate and control delivery of accurate and timely workers' compensation benefits, monitor medical management, and determine accurate and adequate reserves on assigned claims.
Provide accurate assessments and negotiate fair and efficient claim resolutions while managing costs. Settle losses according to the documented damage, policy language, regulatory and statutory considerations, and within granted authority.
Prepare written communications, including settlement letters, disclaimers of coverage, and reservation of rights letters.
Maintain effective claim file documentation and diary system; monitor diary to ensure timely development and disposition of the claim.
Recognize and pursue recovery opportunities and prepare submissions to SIU when indicated.
Assign and supervise vendor resources, including independent adjusters, engineers, and other experts as needed.
Any additional duties as defined.
Requirements / Qualifications
Bachelor's degree preferred
5-8 years in the handling of Workers’ Compensation Claims
Knowledge of Workers’ Compensation Law
Multi-line claim handling experience beneficial
Ability to work independently in a home-based environment
Strong communication and analytical skills
Ability to negotiate skillfully in difficult situations
Strong organizational and time management skills
Ability to formulate sound expense, indemnity, and loss evaluations and present them effectively
State licensing or certification where required
Basic computer skills including Microsoft Word, Excel, Outlook, and Internet
Ability to perform work-related mathematical problems and calculations
Clear and concise written communication; proper English grammar, punctuation, and spelling
Ability to use commonly used claims concepts, practices, and procedures
Effective verbal and written communication skills
Complete formal training plan and assignments as required
Commitment to nondiscriminatory, lawful, and ethical conduct
Adherence to safe work practices
Compensation
$68,700 - $100,000 commensurate with experience, plus bonus eligibility
$75,600 - $115,000 commensurate with experience in CA, CT, MA, NJ, NY, and PA, plus bonus eligibility
Benefits
Competitive base salary plus incentive plans for eligible team members
401(k) retirement plan with company match up to 6%
Free basic life and AD&D, long-term disability and short-term disability insurance
Medical, dental and vision plans
Wellness incentives
Generous time off, including personal, holiday and volunteer PTO
Flexible work schedules and hybrid/remote options for eligible positions
Educational assistance
#TMG
Location: Folsom, CA — Remote opportunity
#J-18808-Ljbffr