status of claim, subrogation activities, etc.) to resolve issues, facilitating communication among parties and/or providing information or directions Provides timely, balanced, and accurate claims reviews, documentation, and decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations Serve as the face of the company in providing frequent, proactive verbal communication with our claimants, customers and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits, and other pertinent policy provisions Documents conversations within the claim files in a timely manner utilizing the appropriate level of detail and professional writing skills Interacts and communicates effectively with claimants, customers, health care providers, attorneys, brokers, and family members during the Claim Specialist’s claim evaluation Compiles file documentation and correspondence requiring extensive policy analysis and factual detail Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available Collaborates with both external and internal resources, such as physicians, attorneys, and vocational consultants to gather data such as medical/occupational information to ensure claim decisions are well-reasoned and thorough Identifies, clarifies, and reconciles inconsistencies when gathering information during claim evaluations and collaborates with underwriting and Fraud Waste and Abuse resources as needed Identifies offsets and proficiently calculates monthly benefits due after elimination period, to include COLA, Social Security Offsets, Residual Disability, and non-routine payments Addresses and resolves escalated customer complaints in a timely and thorough manner Performs other duties as assigned Qualifications Proven time management and follow-through skills with the ability to work on multiple tasks with tight deadlines Highly detail-oriented and excellent organizational skills Prior experience with independent judgement, critical thinking and decision making Display superior written, oral communication skills and effective listening skills Highly motivated team player, with a demonstrated passion for excellence and taking the initiative Regulations Demonstrated conceptual thinking, risk management, ability to handle complex situations effectively Excellent customer service skills proven through internal and external customer interactions Strong analytical skills with numbers Knowledge of Microsoft Outlook, Word, and Excel Ability to effectively manage multiple systems and technology sources Education and/ or Experience Bachelor's degree or a combination of education and related experience 7 years of Workers’ Compensation, liability, property, auto, general liability claims handling experience required Construction experience preferred Prior experience working on damages and investigative work in support of contractual disputes, claims, and litigation Must have a valid Driver's license and acceptable driving record Multi-jurisdictional understanding of legal issues Why Join ESOP Retirement Benefits are extended to all employees with participation after one year of service. Claims Specialist US-CA-Jurupa Valley Job ID: 2026-1097 Type: Full-Time of Openings: 1 Category: Risk Management Jurupa Valley - PCC Overview The Claims Specialist is responsible for evaluating, processing, and managing liability, property, auto, general liability claims, and employment claims in compliance with state regulations; documenting activities; conveying information regarding claims and/or benefits; and providing testimony in benefit disputes while exercising discretion, independent judgment, critical thinking skills and demonstrate exemplary customer services skills.