Workers Compensation (CA) Claims Specialist

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.

At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.

Alternative Markets specialized in mono-line and/or multi-line primary programs on either a traditional guaranteed cost (Specialty Programs) or risk-sharing basis (Agency, Association or Group Captives). Alternative Markets focuses on niche programs.

https://www.greatamericaninsurancegroup.com/about-us/business-operations/division/alternative-markets

Our Alternative Markets Division is looking for a Claims Specialist to join their Workers Compensation team. The ideal candidate would have a background in CA WC Claims.

Essential Job Functions and Responsibilities

• Manages a large inventory of claims, including medical only, indemnity and potential CAT

• Plans and conducts complex claims investigations to confirm coverage, casual relationship, benefits in compliance with state laws

• Analyzes and negotiates appropriate claim settlements/reserves within prescribed authority. May attend arbitrations, mediations, depositions, or trials.

• Authorizes payments in accordance with assigned authority limit and ensures payments are made in a timely manner.

• Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements.

• May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports.

• Performs other duties as assigned.

Job Requirements

• Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field or equivalent experience.
• Generally, a minimum of 9 years of experience in workers compensation claims handling. Completion of or continuing progress toward a professional designation preferred, such as Associate in Claims (AIC).
• Scope of Job/Qualifications: Works within broad limits and authority on assignments of the highest technical complexity, requiring specialized knowledge. Demonstrates excellent analytical, negotiation, and problem-solving skills. Maintains strong knowledge of insurance policies, coverage, and claims handling procedures. Maintains knowledge of industry laws and regulations. Advanced ability to organize and prioritize caseloads, ensuring timely resolution of claims.  Excellent interpersonal and communication skills with the ability to build relationships and lead negotiations. Proven ability to handle confidential information with discretion. Viewed as a senior resource within the Claims department and/or organization.

Business Unit:

Salary Range:

Benefits:

We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.

Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers.

*Excludes seasonal employees and interns.