Sr Claim Examiner-WC (CA)

Crawford & Company; Brea (CA); Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Great work from home opportunity

Excellent benefits package

Bonus opportunity

Employee referral bonus program

Employee discounts

Job summary

Crawford & Company in California seeks a Senior Claims Examiner – Workers' Compensation to manage complex, large-loss claims with autonomy. SIP Certification is required and experience handling CA WC claims is essential.

You will analyze claim liability, manage reserves, and negotiate settlements, collaborating with defense counsel and mentoring newer staff in a dynamic team. This role supports training and claims optimization across a mature program.

Qualifications

• Bachelor's degree or equivalent experience required.
• Technical claims investigations/settling experience within 4–8 years.
• Ability to work independently while handling technical subjects.
• Strong written and oral communication, negotiation and presentation skills.
• Advanced analytical and problem-solving skills with multi-project prioritization.
• Effective interpersonal skills with internal and external clients.
• Industry designations preferred: IIA, AIC, AEI, CPCU.

Responsibilities

• Investigate, evaluate, and resolve advanced, large-loss workers compensation claims with autonomy.
• Analyze compensability, determine liability, manage reserves, and negotiate settlements.
• Partner with defense counsel on litigated matters and mentor new hires.
• Interpret coverages, manage complex claims, and direct discovery/litigation strategy.
• Analyze activity and prepare reports for clients, carriers, and management.
• Establish reserves and authorize payments within authority to settle cost-effectively.
• Develop subrogation opportunities and participate in claim reviews.

Skills

Independent work

Communication skills

Analytical thinking

Interpersonal skills

Negotiation

Presentation skills

Education

Bachelor's degree or equivalent experience

Job description

Job Description

We’re looking for a Senior Claims Examiner – Workers Compensation (California) with a passion for claims management to join our team!

SIP Certification is required

Proven Experience Handling California Workers Compensation Claims

Strong background in managing advanced, large-loss, and complex cases

Role Overview

• 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.

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.

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.

Why Join Crawford & Company

Great Work From Home Opportunity

Excellent Crawford Benefits that Empower Financial, Physical, and Mental Wellness

Great Bonus Opportunity

Generous Employee Referral Bonus Program

Access to Multiple Employee Discounts

About Us

Why Crawford? Because a claim is more than a number - it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community - one claim at a time.

At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us.

We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.

Education

When you accept a job with Crawford, you become a part of the One Crawford family. And as part of the One Crawford family, we offer a comprehensive Total Rewards package to our employees to assist with their financial, health/wellness, continuing education/training and other needs:

• Competitive base pay
• Bonus/Incentive Pay and other Performance-Based Rewards, if applicable.
• We offer a well-rounded benefits package that encourages wellness and helps our employees to be an educated healthcare consumer. The core benefits* offered include:
  • Medical, Dental and Vision Plans
  • Prescription Drugs
  • HSA, HRA, and FSA Accounts
  • Paid Holidays, Vacation and Sick Leave
  • 401(k) Retirement Plan
  • Tuition Assistance
  • Paid Parental Leave
  • Supplemental Health Benefits

The Pay Range/Salary represents the anticipated low and high pay that may be offered for this position. To determine the actual offer, Crawford considers a wide range of factors including the candidate’s previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours.

Other Benefits

• Virtual Physical Therapy
• Caregiving Services
• Life Assistance Program
• The above information highlights some of the benefits currently available to eligible full-time employees.
• Training programs that promote continuous learning and career progression while enhancing job performance.
• Sustainability programs that give back to the communities in which we live and work.
• A culture of respect, collaboration, entrepreneurial spirit and inclusion.

Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.