Senior Claims Examiner - Workers Compensation

Position Summary

Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority on moderate-to-difficult claims.

Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices.

Evaluates and sets reserves using independent judgment. Assists supervisor and company attorneys in preparing cases for litigations.

Conducts training and mentors new hires.

Responsibilities

• Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
• Manages all aspects of investigative activity on complex claims. Directs the discovery and litigation strategy with legal counsel.
• Analyzes claims activity and prepares reports for clients / carriers and management.
• Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements.
• Settles claims promptly and equitably and issues company drafts in payments for claims within authority limits.
• Develops subrogation and third party recovery potential and follows reclaim procedures.
• Analyzes claims activities and prepares reports for clients, carriers and / or management. Participates in claim reviews.

Requirements

• Bachelor's degree or equivalent experience.
• Technical claims investigations / settling experience with 4-8 years experience in Claims or similar organization.
• Workers Compensation (WC) Adjuster License required according to jurisdictional requirements.
• Ability to work independently while assimilating various technical subjects.
• Strong written and oral communication, negotiation and presentation skills.
• Advanced analytical and problem solving skills, with the ability to manage and prioritize multiple projects.

Preferred :

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

When you accept a job with Crawford, you become a part of the One Crawford family.

• Our total compensation plans provide each of our employees with far more than just a great salary
• Pay and incentive plans that recognize performance excellence
• Benefit programs that empower financial, physical, and mental wellness
• Training programs that promote continuous learning and career progression while enhancing job performance
• that give back to the communities in which we live and work
• A culture of respect, collaboration, entrepreneurial spirit and inclusion
16 days ago