Sr Claim Examiner-WC (CA)

About the position 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 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.

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.

Requirements

• 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.
• Workers Compensation (WC) Adjuster License required according to jurisdictional requirements
• SIP certification is required
• Proven experience handling California Workers Compensation claims
• Strong background in managing advanced, large-loss, and complex cases

Nice-to-haves

• Preferred: IIA, AIC, AEI, and/or CPCU.

Benefits

• 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

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