Claims Examiner, WC
Crum & Forster Insurance Co - Morristown, NJ

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Claims Examiner – Workers’ Compensation

POSITION DETAILS
Examines claims data and conducts investigation to develop facts for determination of coverage, liability, compensability, subrogation, etc. for assigned state(s) Workers' Compensation claims. Adjusts and manages claims within the limit of assigned authority.

RESPONSIBILITIES
- Review claims for insurance coverage
- Handle more complex issues involved in a WC claim
- Complete initial investigation of a claim including three-point contacts
- Review claim to determine compensability
- Monitor claim
- Process bills and all other benefit payments
- Adhere to assigned state(s) WC guidelines including the issuance of forms
- Attend necessary training to stay abreast of the assigned state(s) Labor Code
- Work closely with WC Claims Supervisor in management of litigated claims
- Work with Claims Assistant, delegating tasks as necessary
- Assist with account coordination and claim reviews
- Function as account contact
- Work closely with other departments such as Loss Control, Underwriting, Marketing and Home Office claims

Requirements
- CT WC license is desirable
- Minimum of 5 years' experience with WC claims
- Some job-related training courses a plus
- High school diploma is required; some college or degree a plus
- Occasion travel (approx once per quarter) is required