Senior Claim Examiner - Workers Compensation (CA)
Requisition ID
2024-26314
Job Locations
US-CA-Folsom
Position Type
Regular Full-Time
Category
Claims
Business Unit
BUS TPA US
Excellence In Everything We Touch
Position Summary
GREAT WORK FROM HOME CAREER OPPORTUNITY!
- Seeking candidates with experience managing California Workers Compensation claims!
- SIP is a requirement!
- Bonus Opportunities!
- Multiple Employee Discounts!
Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority on moderate-to-difficult claims.
Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices.
Evaluates and sets reserves using independent judgment. Assists supervisor and defense attorneys in preparing cases for litigations.
Conducts training and mentors new hires.
Responsibilities
- 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.
Requirements
Bachelor's degree or equivalent experience required.
Workers Compensation (WC) Adjuster License required according to jurisdictional requirements
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.
Preferred :
IIA, AIC, AEI, and / or CPCU Designations.
About Us
Why Crawford?
Because a claim is more than a number - it's a person, a child, a friend. It's anyone who looks to Crawford on their worst days.
And by helping to restore their lives, we are helping to restore our community - one claim at a time.
At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve.
We're looking for the next generation of leaders to take this journey with us.
We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve.
Though our reach is vast, we proudly operate as One Crawford : united in purpose, vision and values. Learn more at www.crawco.com.
When you accept a job with Crawford, you become a part of the One Crawford family.
- Our total compensation plans provide each of our employees with far more than just a great salary
- Pay and incentive plans that recognize performance excellence
- Benefit programs that empower financial, physical, and mental wellness
- Training programs that promote continuous learning and career progression while enhancing job performance
- Sustainability programs that give back to the communities in which we live and work
- A culture of respect, collaboration, entrepreneurial spirit and inclusion
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.
LI-EM3
Need help finding the right job?
We can recommend jobs specifically for you!
Click here to get started.
Claims Examiner - Workers Compensation (AGILE Roseville, CA)
To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service req...
Workers Compensation Claims Examiner | Roseville, CA
To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service req...
Claims Examiner - Workers Compensation
Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Subject matter expert of appropriate ins...
Workers Compensation Claims Examiner | Roseville, CA (Agile Schedule)
To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service req...
Regional Claims Supervisor - Workers Compensation - Remote
As a member of our Claims management team supervise claims staff to ensure appropriate claim outcomes through consistent execution of best claims practice. In this role utilize your prior claims and management experience to achieve business plan goals and to ensure compliance with legal statutes, po...
Workers Compensation Claims Adjuster | Dedicated Account | Rancho Cordova, CA (Agile Schedule)
Workers Compensation Claims Adjuster | Dedicated Account | Rancho Cordova, CA (Agile Schedule). To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and sp...
Workers Compensation Claims Technician, Medical Only
Claims Technicians obtain essential information in order to process routine workers' compensation (WC) claims with on-going medical management for medical pension claims. This position may be filled as a Workers Compensation Claims Technician or Workers Compensation Senior Claims Technician. Verifie...
Workers Compensation Claims Assistant
Essential Duties and Responsibilities: Prepares new claims files Calculates TTD, Wage Loss, VRMA and PD benefits Issues compensation payments on diary schedule Issues Benefit Notices Doctor status calls and Employee/Employer contact calls Employer contact calls to confirm light duty/modifies work Wo...
Workers Comp Claims Specialist -CA Remote
Ensures that claims handling is conducted in compliance with applicable statutes, regulations and other legal requirements, and that all applicable company procedures and policies are followed. Our offerings include traditional insurance and innovative alternative risk transfer (ART) programs, inclu...
Workers' Compensation Senior Counsel
As a Senior Counsel with Travelers you'll be responsible for high quality, proactive case handling and will have the opportunity to use your legal expertise and litigation skills to independently handle a caseload of higher exposure cases and more complex litigation matters and deliver optimal resul...