Claims Investigator: Medical & Liability Claims

Crawco; Boise (ID); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Medical, Dental and Vision plans

401(k) Retirement Plan

Paid Holidays, Vacation and Sick Leave

Tuition Assistance

Paid Parental Leave

Disability and Life Insurance

Job summary

Crawford & Company is seeking a Senior Administrative Support in Boise, ID to administer and resolve non-complex short term medical and other claims within delegated authority. The role requires strong claims knowledge, medical terminology understanding, and excellent communication with claimants, witnesses, and medical professionals.

Responsibilities include verifying coverage, establishing reserves, documenting medical reports, and approving payments up to $2,500 after coverage is determined.

Qualifications

• College degree or equivalent education/experience.
• Knowledge of claims terminology gained through industry experience or courses.
• Understanding of basic medical terminology and tests relevant to claimed conditions
• Effective oral and written communication skills.
• Customer-focused approach and ability to identify customer needs
• Must have or maintain required state licenses for adjuster/management level and a valid driver's license.

Responsibilities

• Investigates claims to confirm coverage, liability, and damages.
• Verifies policy coverage and determines reserve requirements.
• Identifies wage loss expenses on medical claims.
• Documents medical reports and communicates with claimants and medical professionals.
• Approves payments of medical bills up to $2,500 after compensability.
• Keeps management informed and completes reporting forms.
• Performs related duties as required.

Skills

Investigations & claims analysis

Effective communication

Customer-focused approach

Knowledge of claims terminology

Education

College degree or equivalent

Associate in Claims designation

Job description

Crawford & Company is seeking a Senior Administrative Support in Boise, ID to administer and resolve non-complex short term medical and other claims within delegated authority. The role requires strong claims knowledge, medical terminology understanding, and excellent communication with claimants, witnesses, and medical professionals.

Responsibilities include verifying coverage, establishing reserves, documenting medical reports, and approving payments up to $2,500 after coverage is determined.