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Sr Claim Examiner-WC (CA)

Crawford Job Listings - GlobalBrea🇺🇸United States

Quick overview

SeniorityMid Senior
Employment typeFull Time
Work modeRemote
LocationBrea, United States
LitigationWorkers Compensation

Job description

📣 We’re Hiring: Senior Claims Examiner - Workers Compensation (California)
🌍 This is an exciting opportunity to join a global leader in claims management and make a meaningful impact through your expertise.
✅ Why Join Crawford & Company?
💻 Great Work From Home Opportunity
💼 Excellent Crawford Benefits that Empower Financial, Physical, and Mental Wellness
🎯 Great Bonus Opportunity
⭐ Generous Employee Referral Bonus Program
🛍️ Access to Multiple Employee Discounts
We’re looking for a Senior Claims Examiner - Workers Compensation (California) with a passion for claims management to join our team!
✅ SIP Certification is required
✅ Proven experience handling California Workers Compensation claims
✅ Strong background in managing advanced, large-loss, and complex cases
🔍 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 through training and mentoring 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 required.
  • 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.
  • Industry Designations: Preferred: IIA, AIC, AEI, and/or CPCU.
  • License Requirements:Per State or Jurisdictional requirements.
  • Workers Compensation (WC) Adjuster License required according to jurisdictional requirements

#LI-EM3 #LI-REMOTE

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