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Sr Claim Examiner-WC (CA)
Crawford & Company • Remote • Posted 14 days ago
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Remote • Full-time • Senior Level
Job Highlights
Using AI ⚡ to summarize the original job post
The Senior Claim Examiner - Workers Compensation at Crawford & Company is a remote position focused on managing California Workers Compensation claims. This role involves investigating and settling advanced, large loss, complex claims under minimal supervision, including interpreting policy coverages, managing investigative activity, analyzing claims activity, and settling claims in a cost-effective manner. The position requires a Bachelor's degree or equivalent experience, a Workers Compensation Adjuster License, and 4-8 years of technical claims investigations/settling experience.
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/or 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
Required
- 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 Crawford & Company
Crawford & Company is a leading brand in the insurance and risk industry, offering effective third-party administration solutions. They provide services like loss adjusting, medical management, and managed repair to help restore and rebuild after a loss occurs. With innovative technology and specialized services such as counter fraud and cyber risk mitigation, Crawford aims to deliver value when needed and cater to various industries.
Full Job Description
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 (https://www.crawco.com/about/social-responsibility) 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
Posted Date2 weeks ago(9/6/2024 6:15 AM)
Requisition ID2024-26145
Job LocationsUS-CA-Fresno
Position TypeRegular Full-Time
CategoryClaims
Business UnitBUS_TPA US
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 (https://www.crawco.com/about/social-responsibility) 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
Posted Date2 weeks ago(9/6/2024 6:15 AM)
Requisition ID2024-26145
Job LocationsUS-CA-Fresno
Position TypeRegular Full-Time
CategoryClaims
Business UnitBUS_TPA US
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