Sr Claim Examiner- WC

Crawford & Company • Fairfax, VA

6d • Remote

About The Position

The Sr Claim Examiner investigates and settles advanced, large-loss, and complex workers’ compensation claims promptly and equitably under minimal supervision. The role works within established authority on moderate-to-difficult claims; reviews coverage; determines liability and compensability; gathers information; arranges property damage appraisals; and settles claims using claims best practices. The examiner evaluates and sets reserves using independent judgment, assists supervisors and company attorneys in preparing litigation cases, and trains and mentors new hires.

The position manages investigations and litigation strategy on complex claims, analyzes claim activity and prepares reports for clients, carriers, and management, and participates in claim reviews. It also develops subrogation and third-party recovery opportunities and ensures timely, cost-effective payments within authority limits.

Crawford describes its culture as one of growth, innovation, collaboration, respect, inclusion, and community involvement. The company offers eligible full-time employees a Total Rewards package that includes competitive base pay, potentially applicable performance-based rewards, core benefits, additional no-cost benefits, and training programs that support continued learning and career progression. The position is identified as remote in the posting’s “#LI-Remote” tag.

Requirements

• Bachelor’s degree or equivalent experience.
• Four to eight years of technical claims investigation and settlement experience in Claims or a similar organization.
• Workers’ Compensation (WC) Adjuster License, as required by jurisdiction.
• 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.

Nice To Haves

• Industry designations such as IIA, AIC, AEI, and/or CPCU are preferred but not required.

Responsibilities

• Interpret policy coverages and use independent judgment to determine whether coverage applies to submitted claims, including complex and unusual situations.
• Manage investigative activity on complex claims and direct discovery and litigation strategy with legal counsel.
• Analyze claim activity and prepare reports for clients, carriers, and management.
• Establish reserves using independent judgment and expertise, and authorize payments within the scope of authority.
• Settle claims promptly, equitably, and cost-effectively; issue company drafts for authorized claim payments and ensure timely disbursements.
• Develop subrogation and third-party recovery opportunities and follow reclaim procedures.
• Participate in claim reviews.
• Assist supervisors and company attorneys in preparing cases for litigation.
• Train and mentor new hires.
• Review coverage, determine liability and compensability, secure information, and arrange property damage appraisals.

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 supporting continuous learning and career progression.

What This Job Offers

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