Career Opportunities

Are you a seasoned claims professional who thrives on resolving complex cases with precision, compassion, and grit? Trindel Insurance Fund is seeking a Senior Workers’ Compensation Claims Examiner who brings leadership-level expertise and a human-centered approach to our dynamic team serving rural California counties. This isn’t just another job — it’s an opportunity to:

• Make a meaningful difference in communities you care about
• Collaborate with dedicated risk managers, safety specialists, and legal partners
• Elevate best practices in claims handling, reserving, and employee care

We’re looking for someone who:

• Has extensive experience in workers’ comp claims — including litigation oversight, return-to-work strategies, and stakeholder communication
• Balances regulatory know-how with a genuine commitment to supporting injured workers
• Isn’t afraid to lead with empathy, advocate for smart solutions, and drive continuous improvement

A Senior Workers’ Compensation Claims Examiner, under the supervision of the Director of Workers Compensation, ensures access to any and all benefits necessary to cure or relieve the effects of an occupational injury or illness. The Senior Workers’ Compensation Claims Examiner administers these benefits as required by the California Labor Code. Effectively works with the injured Member and provider to facilitate the Member’s recovery while mitigating risk. This is a highly dynamic and collaborative role that requires outstanding customer service and communication skills.

• Ensure timely and accurate liability decisions and benefit provisions
• Initiate "Three-Point Contact" with member county, injured employee and medical provider.
• Initiate, coordinate, and ensure early return-to-work efforts with worker and member. Proactively manage, finalize, and control an inventory of cases.
• Authorize medical treatment with pre-established authority level.
• Review, investigate, analyze, and adjust workers' compensation claims in accordance with current laws and regulations.
• Establish claims reserves and authorize payments with reserving authority limits.
• Review progress of claims with members, providing a well-documented action plan and acting as a resource for claims questions and guidance.
• Review and process bills for payment in accordance with the established fee schedule and contractual agreements.
• Authorize appropriate payments of medical bills, temporary adn permanent disability, and death benefits within pre-established limits.
• Attend conferences and hearings as necessary to properly administer resolution of claims.
• Coordinate resolution of claims by preparing legal documents, including stipulations, and compromise and release settlements within authority limits.
• Coordinate with defence counsel on litigated claims, providing records and reports, as necessary.
• Consult with and monitors service providers, such as legal counsel, and medical and vocational counselors.
• Refer appropriate claims for potential subrogation recovery.
• Regularly handles private and proprietary information while maintaining strict confidentiality and protection from unautohorized disclosure.
• Stay apprised of current law changes, court rulings, and other related matters that might affect the handling of claims.
• Perform various routine clerical duties, utilizing standard office equipment to include: maintaining calendars; entering information into databases and spreadsheets; making photocopies; faxing documents; typing; and word processing.
• Will require overnight travel to attend training, meetings and claim file reviews.
• Ensure to keep Director of Workers' Compensation apprised of any and all claims requiring special attention, or that have extenuating circumstances.
• Perform other duties as assigned by the Director of Workers' Compensation.
• Perform all work in a safe and effective manner.

• Knowledge of claims administration, case management and cost containment solutions as applicable to Workers' Compensation rules in California including 4850.
• Excellent organizational skills and attention to detail.
• Effective analytical, problem solving and interpretive skills.
• Excellent oral and written communication skills.
• Demonstrated ethical conduct.