Sr Claim Examiner-WC (CA) - Seasonal

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

Job summary

A leading company in the insurance sector is seeking a skilled Claims Adjuster to handle advanced, large loss claims. The role involves independent judgment on complex claims, managing investigative activities, and preparing cases for litigation. Candidates should have a Bachelor's degree and 4-8 years of relevant experience, with strong analytical and communication skills.

Qualifications

• 4-8 years of technical claims investigations/settling experience.
• Ability to work independently and manage multiple projects.
• Preferred industry designations: IIA, AIC, AEI, CPCU.

Responsibilities

• Investigate and settle complex claims promptly and equitably.
• Manage all aspects of investigative activity on complex claims.
• Analyze claims activity and prepare reports for clients and management.

Skills

Analytical skills

Problem-solving

Negotiation

Communication

Interpersonal skills

Education

Bachelor's degree or equivalent 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 utilizing claims best practices. Evaluate and set reserves using independent judgment. Assist supervisor and defense attorneys in preparing cases for litigation. Conduct training and mentor new hires.

Responsibilities

1. Interpret and make decisions using independent judgment on complex and unusual policy coverages, determining applicability to claims submitted.
2. Manage all aspects of investigative activity on complex claims. Direct discovery and litigation strategy with legal counsel.
3. Analyze claims activity and prepare reports for clients, carriers, and management.
4. Establish reserves, using independent judgment and expertise, and authorize payments within scope of authority, settling claims cost-effectively and ensuring timely disbursements.
5. Settle claims promptly and equitably, issuing company drafts within authority limits.
6. Develop subrogation and third-party recovery potential, following reclaim procedures.
7. Participate in claim reviews and analyze claims activities for clients, carriers, and management.

Minimum Requirements

• Bachelor's degree or equivalent experience.
• Technical claims investigations/settling experience with 4-8 years in Claims or similar organization.
• Ability to work independently while understanding various 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 to interact with all levels of internal and external clients.
• Preferred industry designations: IIA, AIC, AEI, and/or CPCU.
• License requirements per jurisdiction, including Workers Compensation (WC) Adjuster License.

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