Senior WC Claims Examiner — Complex & Large-Loss

Crawford & Company; Brea (CA); On-site; USD 95,000 - 135,000; Full time

Benefits offered by this job

Medical/Dental/Vision

HSA/HRA/FSA

Paid Holidays

Tuition Assistance

Job summary

Crawford & Company is seeking a Senior Claims Examiner – Workers' Compensation for California to investigate, adjudicate, and settle complex claims with limited supervision. The role emphasizes independent judgment, reserve setting, and collaboration with defense attorneys. A strong technical background and CA WC experience are required.

You will contribute to training, mentorship, and process improvements while maintaining client relations and timely claim resolutions.

Qualifications

• 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

Responsibilities

• Investigate and settle advanced, large-loss, and complex claims promptly and equitably with minimal supervision.
• Review coverages, determine liability/compensability, collect statements and essential information, and settle claims using best practices.
• Evaluate and set reserves using independent judgment and support litigation preparation with supervisors and defense attorneys.
• Contribute to team development through training and mentorship.
• Develop subrogation and third party recovery potential and follow reclaim procedures.
• Analyze claims activity and prepare reports for clients, carriers and management.

Skills

4-8 years claims experience

Independent work

Communication skills

Analytical problem solving

Interpersonal skills

Education

Bachelor's degree or equivalent

Job description

Crawford & Company is seeking a Senior Claims Examiner – Workers' Compensation for California to investigate, adjudicate, and settle complex claims with limited supervision. The role emphasizes independent judgment, reserve setting, and collaboration with defense attorneys. A strong technical background and CA WC experience are required.

You will contribute to training, mentorship, and process improvements while maintaining client relations and timely claim resolutions.