Sr Claim Examiner- WC

Crawford & Company•Las Vegas, NV

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, evaluates and sets reserves using independent judgment, and settles claims using claims best practices. The examiner also 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 settling 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 internal and external clients at all levels.
Workers’ Compensation Adjuster License, as required by jurisdiction.

Nice To Haves

Industry designations such as IIA, AIC, AEI, and/or CPCU.

Responsibilities

Interpret and make independent decisions on complex and unusual policy coverages, determining 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.
Establish reserves using independent judgment and expertise, and authorize payments within the scope of authority.
Settle claims cost-effectively, promptly, and equitably, ensuring timely issuance of disbursements and company drafts within authority limits.
Identify subrogation and third-party recovery potential and follow reclaim procedures.
Participate in claim reviews.
Assist supervisors and company attorneys in preparing cases for litigation.
Train and mentor new hires.