Sr Claim Examiner-WC (CA)

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 You'll Love It Here:
Excellent Crawford Benefits Supporting Financial, Physical & 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 and settle advanced, large-loss, and complex claims promptly and equitably with minimal supervision.
Work within established authority on moderate-to-difficult claims, reviewing coverages, determining liability/compensability, collecting statements and essential information, and settling claims using best practices.
⚖️ Evaluate and set reserves using independent judgment, support litigation preparation with supervisors and defense attorneys, and contribute to team development through training and mentorship.

• 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

• 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.