Claims Analyst - Workers Comp - Medical Only - West Coast - Remote

Crum & Forster Company Overview

Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A" (Excellent) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.

Our most valuable asset is our people : more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2024 Great Place to Work Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.

C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website : www.cfins.com.

Job Description

The Claims Analyst is responsible for the handling of California jurisdiction medical only Workers Compensation claims to ensure timely and accurate processing and superior customer service. The Analyst is accountable for the accurate determination of the proper amount due the insured or claimant within assigned authority limits and for the compliance with company policies and procedures.

What You Will Do For C&F :

• Verify, identify coverage, compensability issues and conduct limited investigations.
• Identify subrogation, second injury fund and fraud situations and develop information to pursue.
• Conduct timely initial and ongoing contacts and investigation based on best practices guidelines.
• Maintain proper file on all activities and issues.
• Obtain medical records relating to the claim.
• Review claim for necessity and relatedness.
• Provide case management to files with ongoing treatment using authorized outside resources where needed.
• Prepare and submit appropriate state and agency forms timely.
• Assist with account coordination and claims reviews.
• Timely process bills and other benefit payments.
• Work closely and communicate regularly with Underwriting, Risk Engineering, and Account Executives.
• Address questions, concerns and issues from outside parties : insured's, agents, state agencies, injured employees, attorneys.
• Provide superior customer service to agents, insured's and others during the claims handling process.
• When appropriate and necessary, consults with manager or director of claims to obtain authority for activities and settlements that exceed assigned authority.
• Document all significant activities and contacts in the claims file, in accordance with established best practices, company claims handling procedures and applicable state regulations.
• Assist with account coordination and claims reviews.
• Timely process bills and other benefit payments.
• Obtain non-resident adjuster licenses for mandatory states.
• Take continuing education courses to maintain license.

What You Will Bring To C&F :

What C&F Will Bring To You

At C&F you will BELONG

If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know.

For California Residents Only : Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit https : / / www.cfins.com / onlineprivacypolicy / ca / noticeatcollection / for more information.

Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $34,400.00 to a maximum of $64,600.00. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee's contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and / or performance-based variable pay programs.