Sr Claim Examiner-WC (CA)
About The Position
Crawford & Company is hiring a Senior Claims Examiner to handle California Workers Compensation claims. The role investigates, evaluates, and resolves advanced, large-loss, complex, and unusual claims with a high degree of autonomy. It involves determining coverage and compensability, assessing liability, managing reserves, authorizing payments, negotiating settlements, and working with defense counsel on litigated matters. The examiner also analyzes claim activity, prepares reports for clients, carriers, and management, and participates in claim reviews. The role may support team development by training and mentoring new hires. The position requires a bachelor's degree or equivalent experience, 4–8 years of claims or similar experience, SIP certification, experience handling California Workers Compensation claims, and a Workers Compensation adjuster license as required by jurisdiction. Crawford describes this as a work-from-home opportunity and offers a Total Rewards package to eligible full-time employees.
Requirements
- SIP certification is required.
- Proven experience handling California Workers Compensation claims.
- Strong background managing advanced, large-loss, and complex cases.
- Bachelor's degree or equivalent experience.
- 4–8 years of technical claims investigation and settlement experience in Claims or a 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, including the ability to manage and prioritize multiple projects.
- Advanced interpersonal skills to interact effectively with internal and external clients at all levels.
- Workers Compensation adjuster license, as required by jurisdictional requirements.
- License requirements are determined by state or jurisdiction.
Nice To Haves
- Industry designations such as IIA, AIC, AEI, and/or CPCU are preferred.
Responsibilities
- Interpret and make independent decisions about complex or unusual policy coverages and determine whether coverage applies to submitted claims.
- Manage investigative activity on complex claims and direct discovery and litigation strategy with legal counsel.
- Analyze claims activity and prepare reports for clients, carriers, and management.
- Establish reserves using independent judgment and expertise, and authorize payments within scope of authority.
- Settle claims promptly, equitably, and cost-effectively; issue company drafts and ensure timely disbursement of payments within authority limits.
- Develop subrogation and third-party recovery potential and follow reclaim procedures.
- Participate in claim reviews.
- Partner with defense counsel on litigated matters.
- Support team development by training and mentoring new hires.
Benefits
- Competitive base pay.
- Bonus/incentive pay and other performance-based rewards, if applicable.
- 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.
- Enhanced mental health support at no cost.
- Virtual physical therapy at no cost.
- Caregiving services at no cost.
- Life Assistance Program at no cost.
- Training programs that promote continuous learning and career progression.
- Employee referral bonus program.
- Employee discounts.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
