Job description
BCforward is currently seeking a highly motivated Claims Examiner specializing in Workers' Compensation. This is a remote role within California, with hybrid/onsite options available for those within 25 miles of the Rancho Cucamonga office.
Role Overview
This is a high-impact, 3-month contract position focused on complex workers' compensation claims. You will be responsible for managing litigation-heavy cases, negotiating settlements, and managing reserves in a fast-paced environment.
Key Responsibilities
End-to-End Claims Management
- Analyze and manage complex or high-exposure workers' compensation claims.
- Build and execute strategic action plans for timely and effective claim resolution.
- Ensure compliance with service standards, best practices, and client expectations.
Financial & Risk Oversight
- Set, evaluate, and adjust claim reserves throughout the lifecycle.
- Calculate and issue benefits accurately and within regulatory timelines.
- Identify subrogation opportunities and manage recovery processes.
Litigation & Settlement Execution
- Handle litigated claims with a focus on cost-effective resolution.
- Negotiate settlements within authority limits.
- Coordinate with legal teams, vendors, and external partners.
Stakeholder Communication
- Maintain clear, professional communication with claimants, clients, and carriers.
- Provide timely updates on claim activity and status.
- Build and sustain strong client relationships.
Compliance & Documentation
- Ensure accurate claim documentation and coding.
- Prepare and submit state filings within statutory deadlines.
- Report claims to excess carriers and respond to direction requests.
What You Bring to the Table
- 3 years of recent workers' compensation claims experience.
- Strong experience handling lost time claims (mandatory).
- Solid understanding of SIP (Self-Insured Programs) (required).
- Proven ability to manage complex, litigated, or high-exposure claims.
- Strong negotiation, analytical, and decision-making skills.
Preferred Background
- Bachelor's degree from an accredited institution (preferred).
- Professional certifications in claims or insurance (a plus).
- 5 years of claims management experience (ideal profile).
Additional Expectations
- Ability to support quality programs and organizational standards.
- Flexibility to travel if required.
- Willingness to take ownership beyond core responsibilities.
Quick Snapshot
- High-impact, fast-moving claims environment.
- Hybrid flexibility near Rancho Cucamonga office.
- Remote option within California.
- Strong potential for extension.