Sr Claim Examiner- WC

Crawford & Company in; Denver (CO); On-site; USD 90,000 - 130,000; Full time

Job summary

Crawford & Company seeks a Sr Claim Examiner- WC (Finance) to investigate and settle complex workers’ compensation claims. You will review coverages, determine liability, secure information, and arrange appraisals while setting reserves with independent judgment.

You will support supervisors and company attorneys, mentor new hires, and contribute to training and claim reviews to ensure timely, cost-effective settlements.

Qualifications

• Bachelor's degree or equivalent required.
• 4-8 years of claims experience or similar organization.
• Industry designations preferred but not required (IIA, AIC, AEI and/or CPCU).
• WC Adjuster License required per jurisdiction.

Responsibilities

• Investigate and settle advanced, large loss, complex claims promptly and equitably.
• Review coverages, determine liability and compensability, secure information, arrange appraisals, and settle claims.
• Evaluate reserves using independent judgment; assist supervisors and company attorneys in case preparation.
• Mentor new hires; conduct training; direct discovery and litigation strategy on complex claims.
• Analyze claims activity; prepare reports for clients/carriers/management; establish reserves and authorize payments.

Skills

Independent work

Communication (written and oral)

Negotiation

Analytical thinking

Interpersonal skills

Multi-project management

Claims investigations

Education

Bachelor's degree or equivalent

Industry designations (IIA, AIC, AEI, CPCU)

Workers' Compensation Adjuster License

Job description

Sr Claim Examiner- WC (Finance)

Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority on moderate-to-difficult claims. Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices. Evaluates and sets reserves using independent judgment. Assists supervisor and company attorneys in preparing cases for litigations. Conducts training and mentors new hires.

• 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

  #LI-ET1

• 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.