Sr Claim Examiner-WC (CA)

Crawford & Company; California; Remote; USD 90,000 - 130,000; Full time

Benefits offered by this job

Wellness benefits

Employee discounts

Total Rewards package

Remote work option

Job summary

Crawford & Company is seeking a Senior Claims Examiner for California workers' compensation to handle complex, large-loss claims with autonomy. Expect investigation, evaluation, reserving, and settlements in collaboration with defense counsel, plus training and mentoring of new hires.

Qualified candidates will have a bachelor's degree, 4–8 years WC claims experience, SIP certification, and licensure as required by jurisdiction. A strong analytical mindset and communication skills are essential.

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

• 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.
• Establishes reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner.
• 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.

Skills

Independent work

Written communication

Oral communication

Negotiation

Presentation skills

Analytical thinking

Education

Bachelor's degree or equivalent experience

Job description

This is an exciting opportunity to join a global leader in claims management and make a meaningful impact through your expertise.

Great Work From Home Opportunity

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

Access to Multiple Employee Discounts

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

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

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 .

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

• 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.
• 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

* The above information highlights some of the benefits currently available to eligible full-time employees.

Other Benefits currently available at no cost include:

• Enhanced Mental Health Support
• Virtual Physical Therapy
• Caregiving Services
• Life Assistance Program

• 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.