Sr Claim Examiner-WC (CA)

Crawford & Company; Peachtree Corners (GA); A distancia; USD 90.000 - 130.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Great Work From Home Opportunity

Excellent Crawford Benefits that Empow

Great Bonus Opportunity

Generous Employee Referral Bonus

Access to Multiple Employee Discounts

Descripción de la vacante

Crawford & Company is hiring a Senior Claims Examiner for Workers Compensation in California. This role emphasizes independent investigation, evaluation, and resolution of complex claims with a high degree of autonomy.

Candidates should have strong analytical, negotiation, and communication skills, with experience handling large-loss WC claims. The position offers a remote work option, competitive benefits, and opportunities for mentoring new hires while collaborating with defense counsel on

Formación

• Bachelor's degree or equivalent experience required.
• 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

Responsabilidades

• 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 through training and mentoring new hires.
• 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.

Conocimientos

Independent work

Analytical skills

Negotiation

Communication

Interpersonal skills

Claims management

WC claims experience

Litigation coordination

California WC knowledge

SIP Certification

Educación

Bachelor's degree or equivalent experience

Descripción del empleo

We're Hiring: Senior Claims Examiner - Workers Compensation (California)

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

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

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 through training and mentoring new hires.

• 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

#LI-EM3 #LI-REMOTE

• 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.