Sr Claim Examiner- WC

Crawford & Company; Peachtree Corners (GA); On-site; USD 70,000 - 90,000; Full time

Job summary

Crawford & Company located in Peachtree Corners, Georgia is seeking a skilled claims professional to investigate and settle advanced, large-loss claims under minimal supervision. This role requires 4-8 years of experience in claims management and a Bachelor’s degree or equivalent.

The successful candidate will be responsible for managing investigative activities on complex claims, interpreting policy coverages, and preparing reports. Strong analytical and communication skills are essential, along with a Workers Compensation Adjuster License.

Qualifications

• 4-8 years experience in Claims or similar organization required.
• Ability to work independently while managing complex claims.
• Effective negotiation and presentation skills.

Responsibilities

• Interpret coverage decisions using independent judgment.
• Manage all aspects of investigative activity on complex claims.
• Analyze claims activity and prepare reports for clients and management.

Skills

Claims investigations/settling experience

Strong communication skills

Analytical skills

Interpersonal skills

Education

Bachelor's degree or equivalent experience

Workers Compensation Adjuster License

Job description

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.

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.