Claims Specialist- Liab

Crawford & Company in; Fairfax (VA); Hybrid; USD 52,000 - 76,000; Full time

Job summary

Crawford & Company is seeking a remote/hybrid Claims Specialist to efficiently handle short-term, low-complexity claims from a home-based setup. You will document cases, manage open files, and make decisions within delegated authority to ensure timely closures and accurate billing.

The role requires a college degree or equivalent experience, knowledge of claims terminology, and strong communication skills. A customer-focused mindset and ability to interact with various stakeholders are essential.

Qualifications

• College degree or the equivalent education and experience.
• Knowledge of claims terminology gained through industry experience or coursework.
• Demonstrates a thorough working knowledge of claim processing and policies.
• Understanding of basic medical terminology and tests related to claimed conditions.
• Strong written and verbal communication skills.
• Customer-focused approach and ability to identify customer needs.

Responsibilities

• Handle Fast Track and Incident-Only claims with speed and accuracy.
• Document details and manage open files to keep cases moving.
• Make informed decisions within delegated authority.
• Ensure timely closures and accurate billing.
• Conduct investigations to confirm coverage, liability, and damages.
• Prepare updates and reports for supervisors and clients.

Skills

Effective communication

Customer-focused

Attention to detail

Documentation & file management

Decision making within authority

Education

College degree or equivalent experience

Associate in Claim designation (preferred)

Job description

Claims Specialist- Liab (Finance)

We're Hiring! Remote Claims Specialist - Hybrid

Ready to level up your career from the comfort of your home? Join us as a Claims Specialist and take the lead in driving fast, accurate resolutions for short-term, low-complexity claims.

What You'll Do:

• Handle Fast Track and Incident-Only claims with confidence and speed
• Keep cases moving by documenting details and managing open files
• Make informed decisions within your delegated authority
• Ensure timely closures and smooth, accurate billing

If you're organized, proactive, and thrive in a fast-paced environment-this is your moment. Help us deliver exceptional claims experiences every day!

• 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.

#LI-ET

• 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.