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Complex Claims Jobs in California (NOW HIRING)

Senior Claims Examiner

Anaheim, CA ยท On-site

$69K - $89K/yr

Venbrook works across the claims lifecycle with services that include Third Party Administration (TPA), Complex Claims Management, Catastrophe, Independent Adjusting, subrogation recovery, litigation ...

Effectively manages a caseload of 150 to 180 workers' compensation files, including complex claims.* * Initiates and conducts claims investigation in a timely manner.* * Determines compensability of ...

Claims Examiner III (Hybrid)

Fresno, CA ยท On-site

$35 - $43/hr

Effectively manages a caseload of 150 to 180 workers' compensation files, including complex claims.* * Initiates and conducts claims investigation in a timely manner.* * Determines compensability of ...

Showing results 41-60

Complex Claims information

See California salary details

$33.6K

$71.2K

$116.9K

How much do complex claims jobs pay per year?

As of Aug 7, 2026, the average yearly pay for complex claims in California is $71,159.00, according to ZipRecruiter salary data. Most workers in this role earn between $49,300.00 and $87,800.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a complex claims specialist, and why are they important?

To thrive as a Complex Claims Specialist, you need in-depth knowledge of insurance policies, strong analytical skills, and experience in claims investigation, typically supported by a bachelor's degree and relevant industry certifications. Familiarity with claims management systems, legal databases, and specialized software (such as Xactimate or Guidewire) is essential. Exceptional negotiation, critical thinking, and communication skills are crucial for managing sensitive cases and interacting with multiple stakeholders. These skills ensure accurate, fair, and timely resolution of complex claims, minimizing risk and maintaining client trust.

What is the difference between Complex Claims vs Claims Adjuster?

AspectComplex ClaimsClaims Adjuster
Required CredentialsInsurance licenses, certifications in claims handlingInsurance licenses, certifications in claims handling
Work EnvironmentHandling complex, high-value, or specialized claimsAssessing and settling a variety of insurance claims
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent agencies
Common Search & ComparisonComplex Claims vs Claims Adjuster

Complex Claims and Claims Adjusters both require insurance licenses and work within the insurance industry. However, Complex Claims specialists handle high-value, intricate, or specialized claims that demand advanced knowledge and problem-solving skills. Claims Adjusters generally manage a broader range of claims, including straightforward cases. The key difference lies in the complexity and scope of claims managed, with Complex Claims roles focusing on more challenging and detailed cases.

What are the most common challenges faced by professionals handling complex claims, and how can they be managed effectively?

Professionals handling complex claims often encounter challenges such as interpreting intricate policy language, coordinating with multiple stakeholders, and managing large volumes of documentation. To manage these effectively, it's important to develop strong analytical and communication skills, stay organized, and leverage technology for efficient case management. Collaboration with legal teams, underwriters, and external experts is also key to resolving claims accurately and fairly, while ongoing professional development helps keep up with changing regulations and best practices.

What are complex claims?

Complex claims are insurance claims that involve complicated circumstances, multiple parties, or high-value losses, making them more challenging to resolve than standard claims. These claims often require in-depth investigation, specialized expertise, and extended negotiations due to issues like legal disputes, unclear liability, or extensive damages. Handling complex claims typically involves working closely with legal teams, experts, and various stakeholders to ensure a fair and accurate resolution. Insurance companies usually assign experienced adjusters or specialists to manage these types of claims.

What is considered a complex claim?

A complex claim in the context of claims adjusting involves issues that are difficult to evaluate due to multiple factors, such as extensive damages, multiple parties, or legal considerations. These claims often require specialized knowledge, detailed investigation, and sometimes coordination with legal or technical experts to resolve effectively.
Infographic showing various Complex Claims job openings in California as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, 2% Temporary, and 2% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $71,159 per year, or $34.2 per hour.

Senior Claims Examiner

Venbrook

Anaheim, CA โ€ข On-site

$69K - $89K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 6 hours ago


Job description

JOB TITLE: Claims Adjuster, Public Entity
DEPARTMENT: Claims Services
REPORTS TO: Claims Manager / Director of Claims
FLSA STATUS: Exempt
COMPANY OVERVIEW
Venbrook Claims Services is the claims business group of Venbrook Group, LLC, a holding company with subsidiaries engaged in retail broking, wholesale broking, programs, and claims services. Venbrook's team of experts and industry specialists partners with clients to manage their risks, create security, promote growth, and add value by delivering best-in-class commercial property & casualty, employee benefits, and personal risk insurance products and programs.
Venbrook Claims brings together decades of specialized expertise by integrating respected legacy claims brands: Carl Warren & Company, DMA Claims, and OneSource Claims Management. Venbrook works across the claims lifecycle with services that include Third Party Administration (TPA), Complex Claims Management, Catastrophe, Independent Adjusting, subrogation recovery, litigation management, investigative, and Special Investigations Unit (SIU) services.
Venbrook Claims has long-term clients across the public and private sectors, including insurance companies, captives, MGAs, transportation companies, manufacturers, public school systems, and property owners.
With over a century of combined claims experience, our organization's legacy brands have been unified as Venbrook Claims to deliver scalable, flexible solutions supported by centralized governance, compliance, and technology infrastructure. Our culture is derived from the people who create it. We are not different in what we do - we are different in how we do it. We believe our clients are our partners, and we earn their trust every day.
We offer competitive compensation and a comprehensive benefits package:
  • 401(k) + employee match
  • Medical, Dental, Vision, Life, and Disability Insurance
  • Paid Time Off (PTO)
  • Paid Holidays
  • Paid Parental Leave
  • Paid Sick Leave
  • Professional development programs
  • Work-life quality and flexibility

Visit us at https://www.venbrook.com/contact-us/careers
JOB SUMMARY
The Claims Adjuster, Public Entity is responsible for the end-to-end management of property and casualty claims on behalf of public entity clients, including municipalities, school districts, and government agencies. This role requires sound judgment, strong investigative skills, and an understanding of the unique legal and regulatory environment governing public sector claims. The Adjuster will manage litigation, communicate proactively with clients, and deliver high-quality outcomes consistent with client guidelines and best practices.
POSITION COMPETENCIES
Communication Skills: Consistently and effectively communicates with a diverse spectrum of people, including public entity clients, attorneys, claimants, and vendors. Demonstrates active listening and the ability to convey complex claims information clearly to varied audiences - both verbally and in writing.
Problem Solving & Decision Making: Applies sound judgment to determine the best path to claim resolution. Considers short- and long-term effects through the decision-making process, ensuring all relevant stakeholders are engaged and exposures are properly evaluated.
Customer Service Orientation: Aligns efforts to support a client-centric culture. Understands performance expectations, delivers high-quality service, and maintains timely and responsive communication with both internal and external clients.
Interpersonal Skills & Collaboration: Builds and maintains strong working relationships with clients, team members, vendors, and legal partners. Demonstrates resilience, approachability, and the ability to work effectively in a team environment.
Public Entity & Legal Acumen: Demonstrates knowledge of the unique regulatory environment, governmental immunities, and litigation considerations specific to public sector claims. Able to read, interpret, and apply legal documents and case law relevant to public entity exposure.
Strategic Thinking: Continuously monitors claims activity, identifies trends, and makes recommendations to improve outcomes. Maintains awareness of industry and market changes that may impact public entity claim handling.
Functional/Technical Expertise: Demonstrates the ability to investigate, evaluate, and resolve moderate to high-severity claims. Maintains technical expertise through continuing education, designations, and professional development. Proficient in claims management systems and Microsoft Office applications.
Accountability & Integrity: Takes ownership of assigned files, meets deadlines, and holds to the highest standards of professional conduct. Consistently achieves audit and quality benchmarks and operates transparently with clients and leadership.
DUTIES & RESPONSIBILITIES
  • Manage end-to-end handling of auto, general liability, property damage, and bodily injury claims for public entity clients, from first notice of loss through resolution.
  • Execute client strategies to achieve claims quality, customer service, and operational objectives in accordance with Claim Handling Guidelines and Best Practices.
  • Conduct thorough investigations, including field investigations when required, to establish coverage, liability, and damages.
  • Proactively work claims to ensure file quality meets client-specific handling requirements and internal quality standards.
  • Develop resolution strategies with clear, focused, and well-documented file notes reflecting control, momentum, and accuracy.
  • Identify, retain, and actively manage vendors and subcontractors to achieve satisfactory outcomes on both expense and indemnity costs.
  • Maintain a timely diary and caseload management consistent with the age and complexity of assigned files.
  • Achieve audit scores of 90% or above and maintain a high standard of work product quality.
  • Prepare and present client reports, claim reviews, and roundtable summaries as required.
  • Communicate clearly and regularly with clients, claimants, coverage counsel, and defense attorneys.
  • Identify potential fraud, subrogation, and recovery opportunities and take appropriate action.
  • Perform other duties as assigned.

REQUIRED SKILLS & ABILITIES
  • 3+ years of handling litigated auto and/or general liability property damage and bodily injury claims
  • Working knowledge of public entity claims handling, governmental immunities, and applicable statutes of limitations
  • Strong analytical, investigative, and problem-solving skills
  • Excellent verbal and written communication skills
  • Proficiency in claims management systems and Microsoft Office applications (Outlook, Word, Excel, PowerPoint)
  • Ability to read and interpret legal documents, coverage opinions, and reports
  • Ability to manage a high-volume caseload in a fast-paced environment
  • Some travel may be required for field investigations, depositions, and client meetings

EDUCATION & EXPERIENCE
  • 3+ years of P&C claims experience required; public entity claims experience strongly preferred
  • Field investigation experience preferred
  • College degree in Business, Risk Management, or equivalent discipline preferred
  • Insurance designation (e.g., AIC, AIM, ARM, CPCU) and/or insurance-related coursework preferred

Salary Range 80k-90k