Senior Claims Examiner - Workers Compensation
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.
- 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.
- 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.
- Industry designations such as IIA, AIC, AEI and/or CPCU
Think all TPAs are the same? Think again. With Broadspire, our leading global third-party administrator (TPA), Crawford & Company is the consultative outsourcing partner that adapts to businesses needs and challenges at any point of the claims processing journey. We offer casualty claim and medical management services to assist large organizations in achieving their unique goals, increasing employee productivity and reducing the cost of risk through professional expertise, technology and data analytics.
As part of the One Crawford family, Broadspire brings together the best and brightest people in the industry to deliver smart, thoughtful solutions to our clients, and we are guided by our collective value system: RESTORE.
At Crawford, we:
- Respect our culture of integrity and ethical behavior, while embracing the unique talents of the individual and encouraging an ownership mentality among everyone.
- Are Empowered to advance the company mission and take ownership of our individual career progression.
- Promote Sustainability through a corporate culture in which employees are good stewards of their communities.
- Emphasize Training and an environment where employees continually seek and share knowledge and are engaged and satisfied with their work.
- Are One Crawford, embracing a global mindset thats inclusive, agile, mission-focused, and customer-focused.
- Give Recognition, participating in an environment where people are rewarded for jobs well done.
- Embody an Entrepreneurial Spirit, sharing a passion to succeed, innovate, and outpace our competitors.
We believe in leading by example at work and in our communities. We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in mission, vision and values. Learn more at www.crawfordandcompany.com.
In addition to a competitive salary, Crawford offers you:
- Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 70 countries
- On-going training opportunities through every stage of your career
- Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.