CA Future Medical Claims Adjuster

Job Description

Position Overview

Our client a well-established Third-Party Administrator (TPA) is seeking an experienced Future Medical Claims Adjuster to join their growing team. This role is responsible for handling complex workers compensation claims involving future medical exposure ensuring timely and cost-effective resolution while maintaining compliance with California regulations.

Compensation Package

• $60000 - $90000/year (based on experience)
• 100% remote work environment
• Comprehensive benefits package
• Supportive and collaborative team culture
• Long-term stability with a reputable TPA
  
  

Qualifications

• 3 years of California workers compensation claims handling experience
• Specific experience handling future medical exposure required
• Strong understanding of California workers compensation laws and regulations
• Experience negotiating settlements and working with defense attorneys
• Self-insured or TPA background preferred
• Excellent communication organizational and negotiation skills
• Ability to manage a high-volume caseload independently

Key Responsibilities

• Manage a caseload of California workers compensation claims focused on future medical exposure
• Evaluate and determine appropriate reserves including future medical projections
• Coordinate with medical providers legal counsel and vendors to facilitate claim resolution
• Review medical reports and treatment plans to assess ongoing exposure and settlement opportunities
• Negotiate settlements including Compromise & Release (C&R) agreements
• Ensure compliance with California workers compensation laws and regulatory requirements
• Maintain detailed and accurate claim documentation
• Provide excellent customer service to clients claimants and internal stakeholders

Disclaimer: Please note that this job description may not cover all duties responsibilities or aspects of the role and it is subject to modification at the employers discretion.

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