Claims Specialist: Fast-Track & Low-Value Claims

Crawford; Berkeley Heights (NJ); Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

Medical plans

Dental plans

Vision plans

401(k) retirement plan

Tuition assistance

Paid holidays & leave

Job summary

Crawford is seeking a Full-time Sr. Administrative Support in Berkeley Heights, NJ, with remote options for some locations. The role focuses on administering and resolving short-term, low-monetary-amount claims.

You will document case inventories, monitor open files, and act within delegated authority. Responsibilities include investigations, coverage verification, reserve setting, and potential fraud assessment.

Qualifications

• College degree or the equivalent education and experience.
• Demonstrates knowledge of claims terminology gained through experience or coursework.
• Knowledge of claim processing policies and procedures.
• Familiarity with basic medical terminology and tests for claimed conditions.
• Effective and diplomatic oral and written communication skills.
• Must maintain required licenses and a valid driver’s license.

Responsibilities

• Investigates claims to confirm coverage and liability, working with claimants, witnesses and medical professionals.
• Verifies policy coverage and notifies insured of issues; sets reserves within authority.
• Identifies wage loss expenses and wage exposures.
• Documents claim documents (medical, police, etc.) and communicates with claimants.
• Approves payments within authority and reviews status reports.
• Assesses potential fraud issues and recovery opportunities under policy rules.
• Keeps leadership informed of activities and escalates beyond authority when needed.
• Supports subrogation/third party recovery efforts and participates in reviews.
• Performs other duties as required.

Education

College degree

Associate in Claim designation

Job description

Crawford is seeking a Full-time Sr. Administrative Support in Berkeley Heights, NJ, with remote options for some locations. The role focuses on administering and resolving short-term, low-monetary-amount claims.

You will document case inventories, monitor open files, and act within delegated authority. Responsibilities include investigations, coverage verification, reserve setting, and potential fraud assessment.