Sr Claim Examiner- WC

Crawford & Company•United States,

2h•Remote

About The Position

Crawford is hiring a remote Senior Claim Examiner specializing in Workers’ Compensation. The role handles advanced, large-loss, complex, unusual, and high-stakes claims, using independent judgment to make coverage and liability decisions and deliver fair, timely, and cost-effective resolutions. The examiner manages investigations, reserves, payments, settlements, and recovery opportunities, and coordinates discovery and litigation strategy with legal counsel. The role also includes preparing claims reports, participating in claim reviews, and mentoring and training new team members.

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.

Responsibilities

Interpret complex and unusual policy coverages using independent judgment and determine whether coverage applies to submitted claims.
Manage investigative activity on complex claims.
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.
Authorize payments within the scope of authority and settle claims cost-effectively.
Ensure timely issuance of disbursements and company drafts for claims within authority limits.
Settle claims promptly and equitably.
Identify subrogation and third-party recovery potential and follow reclaim procedures.
Participate in claim reviews.
Mentor and train new team members.