Sr Claim Examiner-WC (CA)

Crawford & Company; Folsom (CA); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Comprehensive health plans

401(k) retirement plan

Tuition assistance

Job summary

Crawford & Company is looking for a Senior Claims Examiner for their Folsom, California office. This role entails investigating and settling complex workers compensation claims with minimal supervision.

Candidates should have 4-8 years of relevant experience, a Bachelor’s degree or equivalent, and strong communication skills. The position offers competitive pay and a comprehensive benefits package, including health plans and a 401(k) retirement plan.

Qualifications

• 4–8 years of technical claims investigation/settlement experience in claims or similar.
• Strong written and oral communication skills.
• Ability to manage and prioritize multiple projects.

Responsibilities

• Interpret and decide on complex policy coverages.
• Manage investigative activities on complex claims.
• Analyze claims activity and prepare reports.

Skills

Technical claims investigation

Negotiation

Analytical skills

Education

Bachelor’s degree or equivalent experience

Job description

Job Title

Senior Claims Examiner – Workers Compensation (California)

Location

California

Required Certification

SIP certification is required.

Role Overview

Investigate and settle advanced, large‑loss, and complex claims with minimal supervision, working within established authority. Review coverages, determine liability, collect statements, and settle claims following best practices. Evaluate and set reserves, support litigation preparation, and contribute to team development through training and mentorship.

Responsibilities

• Interpret and make decisions on complex and unusual policy coverages, determining if coverages apply to submitted claims.
• Manage all investigative activities on complex claims, directing discovery and litigation strategy with legal counsel.
• Analyze claims activity and prepare reports for clients, carriers, and management.
• Establish reserves and authorize payments within scope of authority; settle claims cost‑effectively and ensure timely issuance of disbursements.
• Settle claims promptly and equitably, issuing company drafts for payments within authority limits.
• Develop subrogation and third‑party recovery potential, following reclaim procedures.
• Evaluate reserves and support litigation preparation with supervisors and defense attorneys.
• Contribute to team development through training and mentorship.

Qualifications

• Bachelor’s degree or equivalent experience required.
• 4–8 years of technical claims investigation/settlement experience in claims or a 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 interpersonal skills to interact with all levels of internal and external clients.
• Preferred industry designations: IIA, AIC, AEI, and/or CPCU.
• License requirements: Workers Compensation (WC) Adjuster license according to jurisdictional requirements.

Benefits

• Competitive base pay.
• Pay range based on experience, education, market rates, and other factors.
• Bonus and incentive pay, if applicable.
• Comprehensive health plans: medical, dental, vision, prescription drugs, HSA, HRA, and FSA accounts.
• Paid holidays, vacation, and sick leave.
• 401(k) retirement plan.
• Tuition assistance.
• Enhanced mental‑health support.
• Virtual physical therapy.
• Caregiving services.
• Life assistance program.
• Training programs for continuous learning and career progression.
• Community sustainability programs.
• Culture of respect, collaboration, entrepreneurial spirit, and inclusion.

EEO Statement

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.