• Evaluate and manage claims from inception to resolution, ensuring timely and accurate processing.
• Analyze medical, legal, and factual information to determine claim compensability.
• Establish and adjust reserves for medical, legal, vocational, and indemnity costs based on case facts.
• Strategize and direct legal counsel on claim litigation, including discovery, depositions, and settlement negotiations.
• Oversee diaries, communications, payments, and required notices to drive claims toward timely resolution.
• Negotiate and settle claims within designated authority levels.
• Provide mentorship and training to team members, sharing best practices and industry knowledge.
• Represent the company at depositions, hearings, and other legal proceedings as needed.
• Ensure compliance with all state and regulatory requirements.

• High school diploma or GED required; Bachelor's degree preferred.
• Minimum five (5) years of workers’ compensation claims handling experience.
• Strong expertise in claims management, investigation, reserving, cost analysis, and resolution strategies.
• Excellent organizational, analytical, and time management skills.
• Ability to evaluate complex claim data and determine appropriate actions.
• Proficiency in Microsoft Office and ability to learn industry-specific software.
• Strong customer focus with exceptional attention to detail.
• Ability to work independently while collaborating effectively with legal and medical professionals.
• SIP License required (senior level).
• Must meet ongoing training or experience requirements per California Code of Regulations.

If you are a results-driven claims professional with a strategic mindset and a passion for resolving complex cases, we encourage you to apply!

For over 50 years, Nelson Connects has empowered employers and job seekers to achieve their unique versions of success. Our commitment to excellence, integrity, compassion, and innovation has made us a trusted partner in connecting jobs, people, and communities. The remarkably talented and dedicated people of Nelson Connects are building on the rich history of this company to define the future of our industry, and we can’t wait to work with you.

We are Nelson Connects, and our purpose is your success.

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