Workers’ Compensation Senior Claim Representative

We are looking for an experienced Workers’ Compensation Senior Claim Representative to join our team in Los Angeles, California. In this role, you will oversee the management of workers’ compensation lost time claims, ensuring compliance with statutory regulations and delivering exceptional customer service throughout the claims process. This is a Long-term Contract position requiring strong analytical, communication, and organizational skills. Responsibilities: • Manage all aspects of workers’ compensation lost time claims from initial setup to resolution, maintaining high standards of customer service. • Conduct thorough investigations to gather facts, obtain statements, and assess compensability of claims. • Administer statutory medical and indemnity benefits promptly and accurately throughout the duration of each claim. • Collaborate with attorneys to oversee hearings and manage litigation processes effectively. • Establish and adjust reserve amounts for medical, indemnity, and related expenses within authority limits. • Coordinate with vendors, nurse case managers, and rehabilitation managers to ensure optimal medical management and return-to-work initiatives. • Prepare detailed reports documenting investigation outcomes, claim settlements, denials, and evaluations. • Ensure compliance with state regulations by accurately filing workers’ compensation forms and electronic data. • Refer claims for subrogation and facilitate recovery opportunities by securing necessary documentation. • Work closely with internal teams, including Technical Assistants and Special Investigators, to exceed customer expectations and deliver superior claims handling.

• Proven experience as a lost time examiner or in a similar role handling workers’ compensation claims. • Strong knowledge of workers’ compensation statutes, regulations, and compliance requirements. • Proficiency in utilizing data analytics and modeling to expedite claim resolution. • Excellent communication skills, with the ability to interact effectively with insureds, claimants, medical providers, and attorneys. • Strong organizational and time management abilities to handle multiple claims efficiently. • Familiarity with Microsoft Office Suite and other relevant software tools. • Ability to manage vendor relationships and oversee medical management initiatives. • Experience in litigation support and working with legal teams.

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. <a href="https://www.roberthalf.com/us/en/mobile-app" target="_blank">Download the Robert Half app</a> and get 1-tap apply, notifications of AI-matched jobs, and much more. Robert Half will consider for employment qualified applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit <a href="https://roberthalf.gobenefits.net/" target="_blank">roberthalf.gobenefits.net</a> for more information. © 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to <a href="https://www.roberthalf.com/us/en/terms">Robert Half’s Terms of Use</a>.

Los Angeles, CA
remote
Temporary
38.00 - 40.00 USD / Hourly
We are looking for an experienced Workers’ Compensation Senior Claim Representative to join our team in Los Angeles, California. In this role, you will oversee the management of workers’ compensation lost time claims, ensuring compliance with statutory regulations and delivering exceptional customer service throughout the claims process. This is a Long-term Contract position requiring strong analytical, communication, and organizational skills. Responsibilities: • Manage all aspects of workers’ compensation lost time claims from initial setup to resolution, maintaining high standards of customer service. • Conduct thorough investigations to gather facts, obtain statements, and assess compensability of claims. • Administer statutory medical and indemnity benefits promptly and accurately throughout the duration of each claim. • Collaborate with attorneys to oversee hearings and manage litigation processes effectively. • Establish and adjust reserve amounts for medical, indemnity, and related expenses within authority limits. • Coordinate with vendors, nurse case managers, and rehabilitation managers to ensure optimal medical management and return-to-work initiatives. • Prepare detailed reports documenting investigation outcomes, claim settlements, denials, and evaluations. • Ensure compliance with state regulations by accurately filing workers’ compensation forms and electronic data. • Refer claims for subrogation and facilitate recovery opportunities by securing necessary documentation. • Work closely with internal teams, including Technical Assistants and Special Investigators, to exceed customer expectations and deliver superior claims handling.
2025-11-18T22:23:43Z

Workers’ Compensation Senior Claim Representative Job in Los Angeles | Robert Half