Sr Claim Examiner- WC
Full Job Posting
Qualifications
- Bachelor's degree or equivalent experience required. Industry designations preferred but not required (IIA, AIC, AEI and/or CPCU)..
- 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.
- Workers Compensation (WC) Adjuster License required according to jurisdictional requirements
- #LI-ET1 #LI-Remote
Responsibilities
- 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.
Preferred Qualifications
- Bachelor's degree or equivalent experience required. Industry designations preferred but not required (IIA, AIC, AEI and/or CPCU)..
About Crawford & Company Australia Pty Ltd
Global provider of claims management and outsourcing solutions.
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