Sr Claim Examiner-WC (CA)

Crawford & Company; California, Los Angeles (MO, CA); On-site; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a skilled claims adjuster to investigate and settle advanced, large loss claims. This role requires strong analytical and problem-solving skills to manage complex claims independently while ensuring timely and cost-effective resolutions. The ideal candidate will have a Bachelor's degree and 4-8 years of relevant experience, along with excellent communication and negotiation skills. Join a dynamic team where your expertise will contribute to continuous improvement and client satisfaction in the claims process.

Qualifications

• 4-8 years of experience in claims or a similar organization.
• Ability to work independently and assimilate technical subjects.

Responsibilities

• Investigate and settle complex claims promptly and equitably.
• Manage all aspects of investigative activity on complex claims.

Skills

Analytical Skills

Negotiation Skills

Communication Skills

Problem-Solving Skills

Interpersonal Skills

Education

Bachelor's Degree

Technical Claims Investigations Experience

Job description

Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Work within established authority on moderate-to-difficult claims. Review coverages, determine liability and compensability, secure information, arrange property damage appraisals, and settle claims using claims best practices. Evaluate and set reserves using independent judgment. Assist supervisors and defense attorneys in preparing cases for litigation. Conduct training and mentor new hires.

Responsibilities include:

1. Interpreting and making decisions using independent judgment on complex and unusual policy coverages, determining applicability to claims.
2. Managing all aspects of investigative activity on complex claims and directing discovery and litigation strategies with legal counsel.
3. Analyzing claims activity and preparing reports for clients, carriers, and management.
4. Establishing reserves and authorizing payments within scope of authority, settling claims cost-effectively, and ensuring timely disbursements.
5. Settling claims promptly and issuing company drafts within authority limits.
6. Developing subrogation and third-party recovery potential and following reclaim procedures.
7. Participating in claim reviews and analyzing claims activities for continuous improvement.

Minimum qualifications:

• Bachelor's degree or equivalent experience.
• Technical claims investigations/settling experience with 4-8 years in claims or a similar organization.
• Ability to work independently and assimilate technical subjects.
• Strong written and oral communication, negotiation, and presentation skills.
• Advanced analytical and problem-solving skills, with the ability to manage multiple projects.
• Effective interpersonal skills for interacting with all levels of clients and colleagues.
• Preferred industry designations: IIA, AIC, AEI, and/or CPCU.
• License requirements per jurisdiction, including Workers Compensation Adjuster License if applicable.

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