Job Details

Workers' Compensation Lost Time Adjuster (California)

Department: Claims Administration & Adjusting

Employment Type: Permanent - Full Time

Location: San Diego, CA

Reporting To: Judith Ko

Compensation: $39.00 - $43.00 / hour

Description

Our Story

Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North America, we're at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.

We're on the lookout for a Workers' Compensation Lost Time Adjuster to join our growing team. In this role, you'll manage a full caseload of workers' compensation indemnity and lost time claims from inception through resolution. You'll play a key role in delivering high-quality claims outcomes while maintaining strong communication with injured workers, employers, producers, attorneys, and medical providers.

This is a full-time, remote position, with occasional travel required for client claim review meetings.

Key Responsibilities

• Manage workers' compensation lost time and indemnity claims from initial intake through closure
• Conduct and direct investigations to determine AOE/COE, including timely 24-hour three-point contact with injured workers, employers, and medical providers
• Establish initial reserves promptly and maintain accurate reserves based on probable claim outcomes
• Authorize appropriate medical care and ensure timely issuance of indemnity benefits
• Manage all legal aspects of claims, including litigation and settlement negotiations
• Maintain a diary system to ensure timely benefit administration and proactive claim handling
• Determine settlement value and drive claims toward appropriate and timely resolution
• Deliver exceptional customer service to clients, producers, employers, and injured workers through clear and professional written and verbal communication
• Accurately document claim activity and present claim facts to clients, vendors, and management
• Perform additional duties as assigned

Skills, knowledge & expertise

• Bachelor's degree from a four-year college or university; or one to two years of related experience and/or training; or an equivalent combination of education and experience
• California Workers' Compensation experience is required
• Multiple years of experience handling Workers' Compensation claims, including indemnity and litigated claims
• WCCA or WCCP designation
• California Self-Insured Certification
• Proficiency with Microsoft Office Suite and claims management systems
• Excellent written and verbal communication skills with a strong customer service focus
• Strong investigative, analytical, and claim evaluation skills
• Ability to independently manage a caseload in a fast-paced, deadline-driven environment
• Proven organizational, problem-solving, and decision-making abilities
• Self-starter who can work with minimal direction while meeting or exceeding performance goals
• Ability to adapt and maintain a positive, collaborative work atmosphere amid changing priorities

Benefits

Benefits

At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and vision plans to ensure your health and that of your family.
• A 401k plan with employer matching to help you build a secure financial future.
• Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
• Paid holidays.
• Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.

Diversity and Inclusion

Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.

Compensation Transparency:
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.