Sr Claim Examiner-WC (CA)

Crawford • Brea, CA

1d • Remote

About The Position

This is an exciting opportunity to join a global leader in claims management and make a meaningful impact through your expertise. 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. 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 by conducting training and mentoring new hires.

Requirements

• SIP Certification is required
• Proven Experience Handling California Workers Compensation Claims
• Strong background in managing advanced, large-loss, and complex cases
• 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.
• Workers Compensation (WC) Adjuster License required according to jurisdictional requirements

Nice To Haves

• Industry Designations: Preferred: IIA, AIC, AEI, and/or CPCU.

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.

Benefits

• Great Work From Home Opportunity
• Excellent Crawford Benefits that Empower Financial, Physical, and Mental Wellness
• Great Bonus Opportunity
• Generous Employee Referral Bonus Program
• Access to Multiple Employee Discounts

What This Job Offers

• Job Type: Full-time
• Career Level: Senior