Claims Examiner

Title- Sr. Claim Examiner -Workers Compensation (WC)

Client Location: Brea , California

Mode/ Shift - 100% Remote -(M-F 8am to 5pm) (hrs./day:8 and hrs./week:40)

Duration: 4 Months Contract with a possibility of extension

State Client: Crawford & Company

Client ID - 37103742

JOB DESCRIPTION-

Job Category: Claims

Duties:

• 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.
• 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.

Skills:

• 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.

Education:

• 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.
• Preferred: - Industry designations such as IIA, AIC, AEI and/or CPCU