Senior WC Claims Examiner – California (Remote)

Crawford & Company; Fresno (CA); A distancia; USD 90.000 - 120.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, Dental and Vision Plans

HSA, HRA, and FSA Accounts

Paid Holidays, Vacation and Sick Leave

401(k) Retirement Plan

Tuition Assistance

Paid Parental Leave

Descripción de la vacante

Crawford & Company is seeking a Senior Claims Examiner for Workers Compensation in California. Bring expertise to investigate, evaluate, and resolve complex claims with autonomy, leverage SIP certification, and partner with defense counsel.

You will analyze liabilities, manage reserves, and support training. Join a global leader offering growth, mentoring, and a comprehensive benefits package.

Formación

• Bachelor's degree or equivalent experience required.
• Technical claims investigations/settling experience with 4-8 years experience in Claims or similar organization.
• Ability to work independently while assimilating various technical subjects.
• Strong written and oral communication, negotiation and presentation skills.
• Advanced analytical and problem solving skills, with the ability to manage and prioritize multiple projects.
• Effective advanced interpersonal skills to effectively interact with all levels of internal and external clients.
• Industry Designations: Preferred: IIA, AIC, AEI, and/or CPCU.
• License Requirements: Per State or Jurisdictional requirements.
• Workers Compensation (WC) Adjuster License required according to jurisdictional requirements

Responsabilidades

• Investigate, evaluate, and resolve advanced, large-loss, and complex workers compensation claims with a high degree of autonomy.
• Analyze compensability, determine liability, manage reserves, and negotiate claim settlements.
• Partner with defense counsel on litigated matters and support team development by conducting training and mentoring new hires.
• Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
• Manages all aspects of investigative activity on complex claims. Directs the discovery and litigation strategy with legal counsel.
• Analyzes claims activity and prepares reports for clients/carriers and management.
• Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements.
• Settles claims promptly and equitably and issues company drafts in payments for claims within authority limits.
• Develops subrogation and third party recovery potential and follows reclaim procedures.
• Analyzes claims activities and prepares reports for clients, carriers and/or management. Participates in claim reviews.

Conocimientos

Independent work

Strong communication

Analytical thinking

Interpersonal skills

Prioritization

Educación

Bachelor's degree or equivalent

Herramientas

SIP Certification

Descripción del empleo

Crawford & Company is seeking a Senior Claims Examiner for Workers Compensation in California. Bring expertise to investigate, evaluate, and resolve complex claims with autonomy, leverage SIP certification, and partner with defense counsel.

You will analyze liabilities, manage reserves, and support training. Join a global leader offering growth, mentoring, and a comprehensive benefits package.