Job Description📣
We're Hiring: Senior Claims Examiner - Workers Compensation (California)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
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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.
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.
Qualifications- 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
- The Pay Range/Salary represents the anticipated low and high pay that may be offered for this position. To determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours.
- Bonus/Incentive Pay and other Performance-Based Rewards, if applicable.
- We offer a well-rounded benefits package that encourages wellness and helps our employees to be an educated healthcare consumer. The core benefits* offered include:
- Medical, Dental and Vision Plans
- Prescription Drugs
- HSA, HRA, and FSA Accounts
- Paid Holidays, Vacation and Sick Leave
- 401(k) Retirement Plan
- Tuition Assistance
- Paid Parental Leave
- Supplemental Health Benefits
Other Benefits currently available at no cost include: - Enhanced Mental Health Support
- Virtual Physical Therapy
- Caregiving Services
- Life Assistance Program
*The above information highlights some of the benefits currently available to eligible full-time employees.
- 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.
