Sr Claim Examiner- WC

Role Overview

Investigate, evaluate, and resolve advanced, large-loss, and complex Workers Compensation claims with a high degree of autonomy. Analyze compensability, determine liability, manage reserves, and negotiate claim settlements. Partner with defense counsel on litigated matters and support team development by conducting training and mentoring 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 authorize payments within scope of authority, settling claims in the most cost-effective manner and ensuring timely issuance of disbursements.
• 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.

Qualifications

• Bachelor's degree or equivalent experience required.
• Industry designations preferred but not required (IIA, AIC, AEI and/or CPCU).
• Technical claims investigations/settling experience with 4-8 years experience in Claims or 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, with the ability to manage and prioritize multiple projects.
• Effective advanced interpersonal skills to effectively interact with all levels of internal and external clients.
• Workers Compensation (WC) Adjuster License required according to jurisdictional requirements.

About Us

We’re looking for the next generation of leaders to take this journey with us. 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 purpose, vision and values.