Sr Claim Examiner- WC

Posted 2 Days Ago
Be an Early Applicant
Hiring Remotely in Fairfax, VA, USA
In-Office or Remote
Senior level
Fintech • Insurance
The Role
Investigates, evaluates, reserves, negotiates, and settles complex workers’ compensation claims. Determines coverage, liability, and compensability; manages investigations, litigation strategy, subrogation, payments, and claim reporting. Works independently within authority limits, supports attorneys and supervisors, participates in claim reviews, and trains or mentors newer employees. Requires advanced claims expertise, strong analytical and communication skills, and a jurisdictionally appropriate workers’ compensation adjuster license.
Summary Generated by Built In

Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority on moderate-to-difficult claims. Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices. Evaluates and sets reserves using independent judgment. Assists supervisor and company attorneys in preparing cases for litigations. Conducts training and mentors new hires.

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.
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

About Us

Why Crawford?

Because a claim is more than a number - it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community - one claim at a time.

At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us.

We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.

When you accept a job with Crawford, you become a part of the One Crawford family. And as part of the One Crawford family, we offer  a comprehensive Total Rewards package to  our employees  to assist with their financial, health/wellness, continuing education/training and other needs:

  • Competitive base pay
- The Pay Range/Salary represents the anticipated low and high pay that may be offered for this position. To determine the actual offer, Crawford considers a wide range of factors including the candidate’s previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. 
  • Bonus/Incentive Pay and other Performance-Based Rewards, if applicable.
  • We offer a well-rounded benefits package that encourages wellness and helps our employees to be an educated healthcare consumer. The core benefits* offered include:
- Medical, Dental and Vision Plans
- Prescription Drugs
- HSA, HRA, and FSA Accounts
- Paid Holidays, Vacation and Sick Leave
- 401(k) Retirement Plan
- Tuition Assistance
- Paid Parental Leave
- Supplemental Health Benefits
Other Benefits currently available at no cost include: - Enhanced Mental Health Support
- Virtual Physical Therapy
- Caregiving Services
- Life Assistance Program

*The above information highlights some of the benefits currently available to eligible full-time employees.

  • Training programs that promote continuous learning and career progression while enhancing job performance.
  • Sustainability programs that give back to the communities in which we live and work.
  • A culture of respect, collaboration, entrepreneurial spirit and inclusion.

Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V 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.


Skills Required

  • Bachelor's degree or equivalent experience
  • 4-8 years of technical claims investigation and settlement experience in claims or a similar organization
  • Workers' Compensation Adjuster License, according to jurisdictional requirements
  • Industry designations such as IIA, AIC, AEI, or CPCU
  • Ability to work independently while assimilating various technical subjects
  • Strong written and oral communication, negotiation, and presentation skills
  • Advanced analytical and problem-solving skills
  • Ability to manage and prioritize multiple projects
  • Advanced interpersonal skills for interacting with internal and external clients

Crawford & Company Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Crawford & Company and has not been reviewed or approved by Crawford & Company.

  • Flexible Benefits — Feedback suggests role-dependent perks like company cars, remote options, and tuition assistance add practical value, especially for field adjusters. These flexible elements are highlighted as meaningful in certain positions.
  • Retirement Support — Feedback suggests a 401(k) with company match and an ESPP provide solid financial planning options. These programs are consistently referenced as part of a comprehensive package.
  • Healthcare Strength — Feedback suggests medical, dental, vision, and mental-health support are broadly available. These core plans are viewed as standard but reliable inclusions.

Crawford & Company Insights

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The Company
HQ: Peachtree Corners, GA
7,718 Employees
Year Founded: 1941

What We Do

Based in Atlanta, GA Crawford & Company(R) (www.crawco.com) is the world's largest publicly listed independent provider of claims management and outsourcing solutions to carriers, brokers and corporates, with an expansive global network serving clients in more than 70 countries. The company’s shares are traded on the NYSE under the symbols CRD-A and CRD-B.

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