Sr Claim Examiner- WC

Crawford & Company•Denver, CO

8d•Remote

About The Position

Investigate and settle advanced, large-loss, and complex workers’ compensation claims promptly and equitably under minimal supervision. Work within established authority on moderate-to-difficult claims by reviewing coverage, determining liability and compensability, securing information, arranging property damage appraisals, and settling claims using claims best practices. Evaluate and establish reserves using independent judgment. Assist supervisors and company attorneys with litigation preparation, and train and mentor new hires.

Requirements

Bachelor’s degree or equivalent experience.
Four to eight years of technical claims investigation and settling experience in Claims or a similar organization.
Workers’ Compensation 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 and make decisions using independent judgment on complex and unusual policy coverages, determining whether coverage applies to submitted claims.
Manage all aspects of 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; participate in claim reviews.
Establish reserves using independent judgment and expertise, authorize payments within authority, settle claims cost-effectively, and ensure timely disbursement.
Settle claims promptly and equitably and issue company drafts for claim payments within authority limits.
Develop subrogation and third-party recovery potential and follow reclaim procedures.
Assist supervisors and company attorneys in preparing cases for litigation.
Conduct training and mentor new hires.