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, and complex claims with a high degree of autonomy. It involves analyzing compensability and liability, managing reserves, negotiating settlements, and partnering with defense counsel on litigated matters. The examiner may also support team development by training and mentoring new hires. The position requires a bachelor's degree or equivalent experience, 4–8 years of technical claims investigation and settling experience in claims or a similar organization, SIP certification, and a Workers Compensation adjuster license as required by the applicable jurisdiction. The posting describes this as a work-from-home opportunity. Crawford highlights competitive pay, potential performance-based rewards, benefits, employee discounts, and training and career progression opportunities.
Requirements
- SIP certification is required.
- Proven experience handling California Workers Compensation claims.
- Bachelor's degree or equivalent experience.
- 4–8 years of technical claims investigation and settling experience in claims or a similar organization.
- Workers Compensation adjuster license, as required by jurisdictional requirements.
- 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.
- License requirements are subject to state or jurisdictional requirements.
Nice To Haves
- Industry designations such as IIA, AIC, AEI, and/or CPCU.
Responsibilities
- Interpret and make decisions using independent judgment on complex and 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, authorize payments within the scope of authority, and settle claims cost-effectively while ensuring timely disbursements.
- Settle claims promptly and equitably and issue company drafts for 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 and 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
- Virtual physical therapy
- Caregiving services
- Life Assistance Program
- Training programs that promote continuous learning and career progression
- Employee discounts
- Employee referral bonus program
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What This Job Offers
Job Type
Full-time
Career Level
Senior
