Investigate and settle moderate-to-difficult claims for assigned lines of business promptly and equitably under general supervision. Review coverages, determine liability and compensability, secure information, arrange property damage appraisals and settle claims utilizing claims best practices. Set reserves and recommend reserve changes to supervisor and Company attorneys in preparing cases for litigation.
OFFICIAL JOB TITLE: Claim Examiner III - WC
- Receive claim assignment, confirms policy coverages and directs acknowledgement of claims.
- Interpret and make decisions using independent judgment on moderate-to-difficult claims and policy coverages and determines if coverage applies to claims submitted.
- Investigate claims to determine validity and verify extent of damage by telephone contact with clients, claimants, witnesses or other parties as required.
- Analyze 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.
- Settle claims promptly and equitably and issues company drafts in payments for claims within authority limits.
- Develop subrogation and third party recovery potential and follows reclaim procedures.
- Analyze claims activities and prepare reports for clients, carriers and/or management. Participate in claim reviews.
- Bachelor’s degree or equivalent experience required.
- Workers Compensation (WC) Adjuster License required according to jurisdictional requirements.
- Three (3) to Six (6) years of Worker’s Comp – Technical claims investigations/settling experience
- Defense Base Act Workers Compensation Claims Adjusting experience required
- Industry designations preferred, but not required (IIA, AIC, AEI, and/or CPCU).
- Bilingual Spanish a plus but not required
In addition to a competitive salary, Crawford offers you:
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V
- 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 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.
Search for Req 11428
Crawford & Company - 10 months ago