Sr Claim Examiner- WC
Crawford & Company•Dedham, MA
•Remote
About The Position
The Sr Claim Examiner investigates and settles advanced, large-loss, and complex workers’ compensation claims promptly and equitably, working within established authority and with minimal supervision. The role reviews coverage, determines liability and compensability, gathers information, arranges property damage appraisals, and settles claims using claims best practices. It evaluates and sets reserves using independent judgment, assists supervisors and company attorneys with litigation preparation, and trains and mentors new hires.
Requirements
- Bachelor's degree or equivalent experience.
- Four to eight years of technical claims investigation and settlement experience in Claims or a 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, including the ability to manage and prioritize multiple projects.
- Advanced interpersonal skills to interact effectively with all levels of internal and external clients.
- Workers Compensation Adjuster License as required by jurisdiction.
Nice To Haves
- Industry designations preferred but not required, including IIA, AIC, AEI, and/or CPCU.
Responsibilities
- Interpret complex and unusual policy coverages and independently 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; participate in claim reviews.
- Establish reserves using independent judgment and expertise, and authorize payments within the scope of authority.
- Settle claims cost-effectively, promptly, and equitably, and ensure timely issuance of disbursements and company drafts within authority limits.
- Develop subrogation and third-party recovery potential and follow reclaim procedures.
- Assist supervisors and company attorneys in preparing cases for litigation.
- Train and mentor 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
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What This Job Offers
Job Type
Full-time
Career Level
Senior
