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:
Offers Work From Home Position
Salary: $52,309.37 - $95,657.13 / Annually
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

What You'll Do:
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.
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