Claims Specialist- Liab

Broadspire Services, Inc.; Berkeley Heights (NJ); Hybrid; USD 55,000 - 85,000; Full time

Benefits offered by this job

Medical, Dental & Vision

HSA, HRA, FSA

401(k) Retirement Plan

Tuition Assistance

Paid Holidays, Vacation & Sick Leave

Parental Leave

Job summary

Crawford & Company is seeking a full-time claims administrator to assess and resolve non-complex short-term claims, including Fast Track and Incident Only cases, at multiple locations. You will document case activity, monitor inventories, and approve payments within delegated authority.

This role requires a college degree or equivalent experience, knowledge of claims terminology, medical terminology understanding, and a valid license.

Qualifications

• College degree or equivalent education and experience.
• Knowledge of claims and familiarity with claims terminology gained through industry experience and/or specialized courses.
• Thorough working knowledge of claim processing and claim policies and procedures.
• Understanding of basic medical terminology and appropriate medical tests for claimed conditions.
• Effective and diplomatic oral and written communication skills.
• Customer-focused approach including the ability to identify and understand customer needs.
• Must have or secure and maintain the appropriate license(s) and a valid driver's license; CE requirements.

Responsibilities

• Conducts investigations of claims to confirm coverage, liability, compensability, and damages.
• Verifies policy coverage and notifies the insured of issues; establishes reserves within authority.
• Identifies wage loss expenses and wage exposures.
• Documents receipt and contents of claim documents; interacts with claimants and medical professionals.
• Approves payments within scope of payment authority.
• Evaluates claims for potential fraud and loss recovery per policy and state regulations.
• Keeps Team Manager informed of activities and problems; escalates beyond limits as needed.
• Provides input on status reports and completes required forms.
• Prepares updates for supervisor review and assists with subrogation activities.
• Participates in claim reviews and performs related duties as required.

Skills

Communication skills

Customer-focused

Diplomacy

Attention to detail

Education

College degree or equivalent education & experience

Job description

Job Info

• Job Identification 5275
• Job Category USA Field Sr. Administrative Suppo
• Posting Date 09/14/2026, 03:39 PM
• Job Schedule Full time
• Locations 100 Connell Dr, Berkeley Heights, NJ, 07922, US 5335 Triangle Parkway NW, Peachtree Corners, GA, 30092, US (Remote)

Job Description

Administers and resolves non-complex short term claims of low monetary amounts, including Fast Track and Incident Only claims. Documents and monitors open case inventory to ensure proper/timely closing and billing of files. Makes decisions on claims within delegated limited authority.

Responsibilities

• Conducts investigations of claims to confirm coverage and to determine liability, compensability, and damages. Works closely with claimants, witnesses and members of the medical profession and other persons pertinent to the investigation and processing of claims.
• Verifies policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves within designed authority, as necessary, during the processing of the claim.
• Identifies applicable wage loss expenses and wage exposures.
• Documents receipt and contents of claim documents including medical reports, police reports etc. Interacts frequently with claimant to understand nature and extent of injury and medical conditions. Reviews and handles other correspondence within authority including material from the team members, and/or clients.
• Approves payments within scope of payment authority
• Evaluate claims for potential fraud issues, loss control and recovery in accordance with insurance policy contracts, medical bill coding rules and state regulations.
• Keep Team Manager informed verbally and in writing of activities and problems within assigned area of responsibility; refer matters beyond limits of authority and expertise to Team Manager for direction.
• With the team managers' guidance, provides input on the completion of status reports, initiate's activity checks and/or widow's statement of dependency forms.
• Completes all reporting forms and file documentation.
• Adheres to client and carrier guidelines and prepares written updates for supervisor to review.
• Develops subrogation/third party recovery potential and follows recovery procedures
• Participates in claim reviews as applicable.
• Performs other related duties as required or requested.

Qualifications

• College degree or the equivalent education and experience.
• Knowledge of claims and familiarity with claims terminology gained through industry experience and/or through specialized courses of study (Associate in Claim designation, etc).
• Demonstrates a thorough working knowledge of claim processing and claim policies and procedures.
• Demonstrates an understanding of basic medical terminology and appropriate medical tests for claimed conditions
• Demonstrates effective and diplomatic oral and written communication skills.
• Demonstrates a customer-focused approach including the ability to identify and understand customer needs, and interacts effectively with others.
• Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster/supervisory/management level. Must possess a valid driver's license. Must complete continuing education requirements as outlined by Crawford Educational Services. Additional courses may be required by jurisdiction for maintenance of license.

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About Us

Why Crawford?

Because a claim is more than a number - it's a person, a child, a friend. It's anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community - one claim at a time.

At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We're looking for the next generation of leaders to take this journey with us.

We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com .

When you accept a job with Crawford, you become a part of the One Crawford family. And as part of the One Crawford family, we offer a comprehensive Total Rewards package to our employees to assist with their financial, health/wellness, continuing education/training and other needs:

• Competitive base pay
• Bonus/Incentive Pay and other Performance-Based Rewards, if applicable.

The Pay Range/Salary represents the anticipated low and high pay that may be offered for this position. To determine the actual offer, Crawford considers a wide range of factors including the candidate’s previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours.

We offer a well-rounded benefits package that encourages wellness and helps our employees to be an educated healthcare consumer. The core benefits* offered  >10~:

• Medical, Dental and Vision Plans
• Prescription Drugs
• HSA, HRA, and FSA Accounts
• Paid Holidays, Vacation and Sick Leave
• 401(k) Retirement Plan
• Tuition Assistance
• Paid Parental Leave
• Supplemental Health Benefits

Other  >10 currently available at no cost...

• Enhanced Mental Health Support
• Virtual Physical Therapy
• Caregiving Services
• Life Assistance Program

*The above information highlights some of the benefits currently available to eligible full-time employees.

• Training programs that promote continuous learning and career progression while enhancing job performance.
• Sustainability programs that give back to the communities in which we live and work.
• A culture of respect, collaboration, entrepreneurial spirit and inclusion.

Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.