Claim adjuster Jobs in Oceanside, CA

Senior Workers Compensation Adjuster

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we CARE through our values, sustainability initiatives and inclusive corporate culture.

Our Workers Compensation Lost Time Claims department is seeking a Senior Workers Compensation Adjuster for the California team. This is a full-time/exempt role with a schedule that is either hybrid at our Roseville office or fully remote.

POSITION OVERVIEW:

The Senior Workers Compensation Adjuster is responsible for managing moderate to complex and high-value casualty claims with minimal supervision. This role requires advanced investigative and negotiation skills to effectively resolve disputes and handle escalated situations. The Consultant works closely with internal and external experts, including legal counsel and technical specialists, to ensure thorough claim evaluation and resolution.

Key responsibilities include representing the company in various forums related to claims litigation, maintaining a high standard of professionalism, and ensuring compliance with regulatory and company standards. The role demands strategic thinking, sound judgment, and the ability to navigate sensitive and high-impact claim scenarios.

IN THIS ROLE, YOU WILL:

• Independently manage moderate to complex, high-value casualty claims, ensuring thorough analysis and resolution. Lead thorough investigations, assess coverage, and issue appropriate documentation including reservation of rights and coverage letters. Escalate issues as needed.
• Identify opportunities to transfer risk and pursue subrogation. Proactively resolve disputes, deescalate sensitive situations, and ensure optimal claim outcomes through strategic negotiation and litigation management.
• Ensure all claims activities comply with regulatory and company standards. Maintain accurate, detailed records and prepare comprehensive reports. Execute jurisdictional compliance requirements and support others in understanding regulatory obligations.
• Set reserves, authorize payments, and make financial decisions within authority. Demonstrate strong financial acumen and contribute to reserving accuracy and efficiency.
• Coordinate with internal and external stakeholders including legal, underwriting, vendors, and agents. Lead cross-functional meetings and communicate complex information clearly to diverse audiences.
• Use advanced tools and analytics to identify trends, correct inconsistencies, and improve claims handling efficiency. Ensure proper data ingestion, labeling, and protection of personally identifiable information (PII).
• Serve as a mentor to junior claim handlers, providing guidance on complex claims, compliance, and litigation processes. Support training initiatives and contribute to the development of best practices and educational materials.

WHAT YOU NEED TO APPLY:

• Bachelor's degree preferred, or a combination of education and equivalent experience. Typically requires 510 years of claims handling experience.
• Must possess or obtain and maintain appropriate state adjuster licenses and continuing education credits.
• Skilled in negotiating complex claims and developing strategies to influence outcomes. Demonstrates sound judgment and decision-making on high-exposure cases, including litigation and compliance matters.
• Communicates clearly and effectively in both verbal and written formats across a variety of situations. Selects appropriate communication channels and consistently demonstrates empathy toward all stakeholders.
• Highly organized with the ability to manage complex workflows and participate in project work. Demonstrates strong time management and desk management skills, and mentors others in these areas.
• Possesses in-depth understanding of the regulatory environment and jurisdictional requirements. Handles complex compliance issues and mentors others on regulatory standards.
• Provides exceptional, empathetic customer service. Effectively manages escalated claims and sensitive customer concerns with professionalism and clarity.
• Ability to use a personal computer and other standard office equipment.
• Ability to sit and/or stand for extended periods.
• Required to work on-site as needed.
• Ability to travel as necessary.
• Ability to work in a fast paced, changing or stressful environment.
• Ability to perform work in a noisy/loud work environment.
• May be required to have and maintain sufficient home-based internet connection.

This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.

CAREER DEVELOPMENT:

It's not just a job, it's a career, and we are here to support you every step of the way. We want you to be successful and fulfilled. Through on-the-job experiences, personalized coaching and our robust learning and development programs, we encourage you at every level to grow and develop.

BENEFITS:

We offer comprehensive benefits to help you be healthy, build financial security, and balance work and home life. At The Hanover, you'll enjoy what you do and have the support you need to succeed.

Benefits include:

• Medical, dental, vision, life, and disability insurance
• 401K with a company match
• Tuition reimbursement
• PTO
• Company paid holidays
• Flexible work arrangements
• Cultural Awareness Day in support of IDE
• On-site medical/wellness center (Worcester only)
• Click here for the full list of Benefits

EEO statement:

The Hanover values diversity in the workplace and among our customers. The company provides equal opportunity for employment and promotion to all qualified employees and applicants on the basis of experience, training, education, and ability to do the available work without regard to race, religion, color, age, sex/gender, sexual orientation, national origin, gender identity, disability, marital status, veteran status, genetic information, ancestry or any other status protected by law. Furthermore, The Hanover Insurance Group is committed to providing an equal opportunity workplace that is free of discrimination and harassment based on national origin, race, color, religion, gender, ancestry, age, sexual orientation, gender identity, disability, marital status, veteran status, genetic information or any other status protected by law." As an equal opportunity employer, Hanover does not discriminate against qualified individuals with disabilities. Individuals with disabilities who wish to request a reasonable accommodation to participate in the job application or interview process, or to perform essential job functions, should contact us at: HRServices@hanover.com and include the link of the job posting in which you are interested.

Privacy Policy:

To view our privacy policy and online privacy statement, click here.

Applicants who are California residents: To see the types of information we may collect from applicants and employees and how we use it, please click here.

Compensation:

The target hiring range for this role may vary based on geographic location and other factors, including merit or performance, demonstrated proficiency, skills for the role, education, travel requirements, and experience. Additional compensation may include an annual bonus (which could take the form of a general bonus, sales incentive, or short-term incentive), long-term incentive or spot recognition awards. The posted range reflects our ability to hire at different position titles and levels depending on background and experience.