Senior Specialist - Workers Compensation

Crum & Forster • Brookfield, WI

1d • Hybrid

About The Position

Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry. Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion. C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website: www.cfins.com. Examines claims data and conducts investigations into routine and moderately complex claims to determine coverage, compensability, subrogation and benefits under moderate supervisory direction. Adjusts and manages claims within the limit of assigned authority. The home base for this role is in the Brookfield/Milwaukee area. High preference for the candidate to be hybrid in WI.

Requirements

• College degree, B.A. or equivalent experience.
• Minimum of 3 years' experience handling workers compensation claims.
• Strong organizational skills.
• Good time management skills.
• Excellent verbal and written communication skills are essential.
• Strong aptitude and knowledge of Microsoft Office programs and the ability to quickly learn new programs.
• Will abide by departmental policies and procedures, including authority levels, to comply with C&F’s risk management controls.

Nice To Haves

• Foreign language communications a plus.

Responsibilities

• Must be well versed in the following state act jurisdictions: PA, MN, IN, and or IL.
• Receives lost time and complex medical only assignments. Verifies and determines applicability of coverage. Initiates 24-hour contact with employer, employee and 48-hour contact with attending physician.
• Handles catastrophic claims with supervisory oversight.
• Conducts telephone investigations as required by company claims handling manual and procedures.
• Evaluates and adjusts claims within the limits of authority.
• Consults with Claim Manager on those claims where assistance and consultation is needed.
• Makes assignments to nurse case management when indicated, monitoring their billing and performance.
• Sets reserves for anticipated exposure up to authority limits.
• Completes mandatory Reserve Worksheets. Establishes reserves requiring complex analysis with lifetime pharmacy and cost inflation.
• Coordinates return to work (RTW) and sets target dates.
• Maintain diaries on maximum three (3) month intervals.
• Documents files in the claims system.
• Reviews medical bills for causal relationship, medical bill charges for appropriateness and approves payments.
• Adheres to special account handling (SHI) instructions.
• Attends account meetings by telephone and in-person.
• Manages litigation on the files.

Benefits

• Competitive compensation package
• Generous 401K employer match
• Employee Stock Purchase plan with employer matching
• Generous Paid Time Off
• Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family’s wellness, including your physical, mental and financial wellbeing
• A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
• A dynamic, ambitious, fun and exciting work environment
• We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community
• At C&F you will BELONG

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees