Senior WC Claims Examiner: Complex Loss Specialist

Crawford & Company in; Peachtree Corners (GA); On-site; USD 70,000 - 100,000; Full time

Job summary

Crawford & Company is seeking a Sr Claim Examiner- WC (Finance) to investigate, settle and manage advanced, large loss and complex workers compensation claims with minimal supervision.

Responsibilities include reviewing coverages, determining liability, securing information, reserving, and coordinating with attorneys on litigations, while mentoring new hires and supporting claims best practices.

Qualifications

• Bachelor's degree or equivalent experience required. Industry designations preferred but not required (IIA, AIC, AEI and/or CPCU).
• 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.
• Workers Compensation (WC) Adjuster License required according to jurisdictional requirements

Responsibilities

• 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.

Skills

Independent work

Communication skills

Analytical thinking

Interpersonal skills

WC Adjuster licensing

Education

Bachelor's degree or equivalent experience

Job description

Crawford & Company is seeking a Sr Claim Examiner- WC (Finance) to investigate, settle and manage advanced, large loss and complex workers compensation claims with minimal supervision.

Responsibilities include reviewing coverages, determining liability, securing information, reserving, and coordinating with attorneys on litigations, while mentoring new hires and supporting claims best practices.