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Fresno, CA

Date Posted: November 20, 2017
Job Type: Temporary to Hire
Job ID: 289692

Job Description

Workers Compensation Claims Examiner

A reputable company in the Fresno area is looking for an experience Workers Compensation Claim Examiner to join their team. The Claims Examiner will be responsible for handling and resolving complex and/or specialized assigned claims.  This position will make applicable decisions regarding coverage and settlement in addition to reviewing and processing highly complex claims.


  • Make timely and appropriate contacts, determines and completes appropriate level of investigation to make determination of coverage, assess liability and determine damages
  • Determines coverage, prepares coverage correspondence on appropriate claims, responds to coverage questions raised by insureds and others
  • Determines exposure, establishes adequate reserves and makes timely adjustments as required
  • Selects, assigns and directs activities of internal and external resources as required; including independent adjusters, appraisers and attorneys.  Identifies questionable claims and consults with SIU for further direction as appropriate
  • Determines settlement value of the loss and negotiates proper settlement of claims within authority.  Provides recommendations for settlement and disposition of claims exceeding authority level
  • Documents clearly and concisely all relevant activity on assigned files and makes recommendations for additional activity as appropriate
  • Anticipates and meets all customer needs (internal and external).


Strong claims technical knowledge, and legal climate background is essential, California and Colorado/or jurisdictions is required. Possesses strong knowledge of specialized claim types required for specific business unit. Strong analytical and negotiation skills. Must have the ability to interact with customers. Excellent verbal and written communication skills.  Must maintain a high level of accuracy, and provide follow-through on projects.  Requires the ability to maintain confidential information and work independently and as a member of a team.  Demonstrated proficiency with computer software including current Windows Operating System, Microsoft Office, and Microsoft Outlook. 
Education and Experience:
Bachelor’s degree required. Experienced Claims Adjuster Designation (Continued Education Hours Complete) preferred.  The ideal candidate will have 5-7 years of claims experience.