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Claims Examiner

About the Role

We’re seeking an experienced **Claims Examiner (Workers’ Compensation)** to join our client’s team in Orange, CA. The ideal candidate will analyze and manage complex or technically difficult workers’ compensation claims, ensuring timely resolution and adherence to best practices.

You’ll handle high-exposure cases involving litigation, rehabilitation, and settlement negotiations, while maintaining professional client relationships and ensuring compliance with all state regulations.

**Location:** Orange, CA (Hybrid – 2 days onsite per week)

**Pay Rate:** $47/hour

Key Responsibilities

+ Investigate, analyze, and process complex workers’ compensation claims to determine exposure and benefits due.

+ Develop and execute action plans to drive timely and appropriate claim resolution.

+ Negotiate settlements within designated authority.

+ Calculate and manage reserves throughout the life of the claim.

+ Prepare and submit necessary state filings within statutory limits.

+ Manage litigation process, vendor coordination, and cost containment efforts.

+ Handle recoveries, subrogation, and Second Injury Fund/Medicare offsets.

+ Maintain accurate documentation and ensure proper claims coding.

Qualifications

+ **Experience:** Minimum of 3 years of workers’ compensation claims examiner experience (required).

+ **Education:** High School Diploma or GED required; Bachelor’s degree preferred.

+ **Skills:**

+ Strong knowledge of insurance principles, workers’ compensation laws, and medical management practices.

+ Excellent analytical, negotiation, and communication skills.

+ Proficiency with Microsoft Office and claims management systems.

+ Strong organizational and multitasking abilities.

Additional Information

+ **Work Environment:** Hybrid (2 days onsite in Orange, CA).

+ **Security:** Credit and background check required.

+ **Schedule:** Monday – Friday, standard business hours.

As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here (https://www.mykelly.com/help-support-working-with-kelly-us/#Benefits) for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.

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About Kelly

Work changes everything. And at Kelly, we’re obsessed with where it can take you. To us, it’s about more than simply accepting your next job opportunity. It’s the fuel that powers every next step of your life. It’s the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.

Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California’s state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

Kelly Services is proud to be an Equal Employment Opportunity and Affirmative Action employer. We welcome, value, and embrace diversity at all levels and are committed to building a team that is inclusive of a variety of backgrounds, communities, perspectives, and abilities. At Kelly, we believe that the more inclusive we are, the better services we can provide. Requests for accommodation related to our application process can be directed to Kelly’s Human Resource Knowledge Center. Kelly complies with the requirements of California’s state and local Fair Chance laws. A conviction does not automatically bar individuals from employment.